Composite materials are widely used in the design and manufacture of modern civil aircraft fuselage structures. Some large airliners already have full-size composite fuselages, which reduced the weight of the fuselage structure, but the problem of reinforcing the opening of the composite fuselage is also very important. In this paper, the design of medium and large scale open reinforcement structures in composite fuselages is focused. The force characteristics of passenger doors, cargo doors, landing gear hatch openings, and the reinforcement structure form are elaborated, and based on the current research status at home and abroad, the future development of composite fuselage opening reinforcement design is prospected.