High shear wet granulation is widely used in the pharmaceutical industry, however it is still difficult to predict the results of granulation and explain the relevant results. The paper reviews the three key processes in high shear granulation: wetting and nucleation, consolidation and growth, and breakage and attrition, combines with the corresponding models, the dimensionless parameters, regime maps and related mechanisms. Summarizes the basis and methods for judgment of granulation endpoint of final product. And proposed future direction of development of granulation and research ideas, which helps to solve the existing problems in the production and accelerate its development.