Electronic fetal monitoring （EFM） reflects real-time changes in fetal heart rate and serves as an important tool for assessing the intrauterine condition of the fetus. Intrapartum EFM performed against a background of frequent uterine contractions differs from antepartum EFM in terms of interpretive priorities and has significant implications for intrapartum decision-making. Emerging evidence suggests that baseline stability and variability of fetal heart rate correlate with pregnancy outcomes ，warranting increased attention in the interpretation of intrapartum EFM. In recent years，with the continuous updates on international guidelines for intrapartum EFM，the interpretation of intrapartum EFM is shifting from pattern recognition toward pathophysiological mechanism analysis. Individualized interpretation of EFM and assessment of intrauterine fetal condition should be achieved based on EFM characteristics，maternal risk factors，comorbidities，and labor progress，identifying the type of fetal hypoxia and fetal compensatory and decompensatory status and implementing targeted management. This approach of interpretation contributes to improving perinatal outcomes and ensuring maternal and fetal safety.