With the development of society and economy, and the improvement of people’s living standards, obesity has gradually become a significant issue not only in China but globally. Epidural anesthesia, being the most commonly used method for labor analgesia in clinical practice, has significantly reduced the pain experienced by parturients during childbirth and decreased the cesarean delivery rate. However, due to the anatomical and physiological differences between obese and non-obese parturients, the effectiveness and techniques of labor analgesia may vary. This review focuses on the anatomical characteristics and drug differences in obese parturients, the methods of epidural labor analgesia in this population, the application of ultrasound in epidural puncture for obese parturients, and the complications associated with labor analgesia. The goal is to provide a guidance for clinical practice.