In view of the fact that the microscopic fatigue damage of asphalt mixture is difficult to connect with the characterization of macroscopic mechanical properties, the three aspects of fatigue damage mechanism, fatigue test method and fatigue performance characterization model were summarized, and the future development direction was predicted. The results show that the macroscopic fatigue test of asphalt mixture needs to combine mesoscopic analytical methods, such as computerized tomographic scanning, numerical simulation and digital image correlation technique, when evaluating the fatigue performance of asphalt mixture, since asphalt mixture is a kind of multi-phase, multi-component and multi-scale viscoelastic material. The most widely used test method for fatigue performance of asphalt mixture is the indoor small specimen fatigue test. Due to different test conditions set in different test methods, the test results and performance parameters showed significant variability. It should focus on the connection between mesostructural damage cracking pattern of asphalt mixture and macroscopic performance characterization, improve the test conditions of existing fatigue test methods, develop advanced loading equipment with three-dimensional stress state, and increase test scales to reflect the fatigue performance under real load environment, reveal the fatigue characteristics and fatigue damage under historical load conditions based on energy theory and viscoelastic continuous damage.