Focal segmental glomerulosclerosis (FSGS) is defined as a clinicopathological entity of different etiologies and pathogeneses. The clinical manifestations include proteinuria,usually of nephritic range,and are associated with lesions of focal segmental glomerular sclerosis and foot process effacement. The Columbia classification of FSGS based on light microscopic assessment includes five subtypes:collapsing variant,tip variant,cellular variant,perihilar variant,and not otherwise specified. Columbia classification emphasizes the association of clinical with pathologic characteristics. However,both the physiopathology of FSGS and morphogenesis underlying the five morphologic variants are not fully described in Columbia classification. Over the past few years,significant progress has been made in the pathogenesis of FSGS and morphogenesis of diverse variants of FSGS. This review recapitulates recent important advances in the pathogenesis of FSGS and morphogenesis basis underlying the pathological variants of FSGS.