Atopic eczema (AE) is a chronic inflammatory skin disease that is mainly characterized by pruritus and epidermal barrier dysfunction. Between 15% and 20% of children and 1%-3% of adults are affected worldwide. AE is a complex disease triggered by multiple triggers, including gene and environmental factors. Impaired skin barrier function, modifications of the immune system, and hyper-reactivity to environmental stimulation directly cause and aggravate AE. In this review, we provide an overview of the recent developments and future directions in the pathogenesis of AE.