Regional severe haze represents an enormous environmental problem in China, influencing air quality, human health, ecosystem, weather, and climate. These extremes are characterized by exceedingly high concentrations of fine particulate matter (smaller than 2.5 µm, or PM2.5) and occur with extensive temporal (on a daily, weekly, to monthly timescale) and spatial (over a million square kilometers) coverage. Although significant advances have been made in field measurements, model simulations, and laboratory experiments for fine PM over recent years, the causes for severe haze formation have not yet to be systematically/comprehensively evaluated. This review provides a synthetic synopsis of recent advances in understanding the fundamental mechanisms of severe haze formation in northern China, focusing on emission sources, chemical formation and transformation, and meteorological and climatic conditions. In particular, we highlight the synergetic effects from the interactions between anthropogenic emissions and atmospheric processes. Current challenges and future research directions to improve the understanding of severe haze pollution as well as plausible regulatory implications on a scientific basis are also discussed.