In this editorial, we provide a critical review of the article by Tang et al published in the World J Clin Cases , focusing on the utilization of butorphanol for epidural analgesia during labor. Our discussion encompasses recent research developments in epidural labor analgesia, specifically highlighting the current status of clinical applications of butorphanol and associated treatment approaches. Epidural analgesia is widely acknowledged as the primary method for pain management during labor, offering effective and prolonged pain relief while allowing mothers to remain alert and actively participate in the delivery process. Among the various drugs utilized for epidural labor analgesia, butorphanol has received increasing attention due to its potential efficacy and distinctive pharmacological properties. As a synthetic opioid analgesic, butorphanol exhibits both agonistic and antagonistic activity on opioid receptors, striking a balance between analgesia and minimizing side effects. Nevertheless, the safety and efficacy of butorphanol in epidural labor analgesia remains controversial. While certain studies have reported positive outcomes with butorphanol, including effective pain relief and a reduced incidence of side effects, others have raised concerns about its safety and efficacy compared to traditional opioids or alternative analgesics. In addition, the optimal dosing strategy and regimen of butorphanol as an adjuvant in epidural labor analgesia still need to be verified. Through comprehensive synthesis and analysis of existing literature, we aim to evaluate the current evidence regarding the use of butorphanol for epidural labor analgesia, delineate areas of consensus and controversy, and propose future avenues for research and clinical practice in this domain.