Spinal muscular atrophy (SMA) is a lower motor neuron disease that causes muscle atrophy and progressive muscle weakness due to degeneration and loss of spinal cord anterior horn cells. SMA was first described in 1891, and the survival motor neuron1 gene was identified as the cause in 1995. The prevalence of SMA is 1-2/100,000, and the carrier frequency is 1/40-60.The onset of the disease ranges from prenatal to adulthood and is classified into 5 groups (types 0-IV) based on age of disease onset and archived motor functions. Type I onset in infancy is characterized by decreased muscle tone, loss of tendon reflexes, and decreased voluntary movements of the proximal limbs and trunk from approximately 1 to 3 months of age. Sitting posture is not acquired throughout life. As muscle weakness progresses, respiratory function declines, and ventilatory management is introduced at an average age of 6 months. Without ventilatory management, 90% of children die by the age of 2 years due to respiratory infections. There is no treatment other than symptomatic treatment, such as tracheostomy and ventilatory management at home, and it has been considered one of the most serious diseases in the field of pediatric neurology.Recently, international clinical trials have resulted in the development of nusinersen, a nucleic acid drug, onasemnogene abeparvovec, a gene therapy drug, and risdiplam, a small molecule drug. These new therapies have dramatically changed SMA practice. They have halted the progression of symptoms and have the potential to improve not only life expectancy but also neurological prognosis. It is also now possible to prevent the onset of the disease itself by administering the drug before onset. It is becoming more important to diagnose the disease at an earlier stage and to detect and treat the disease before it develops through newborn mass screening.