Introduction: The purpose of the study was to investigate the effects of backpacks on body posture and spinal morphology in children and adolescents, and the relationship between them and back pain in adolescents, in order to provide a theoretical basis for further research in this area. Methods: The literature on backpacks, body posture, spinal morphology and back pain was searched and the results were analyzed. Results: The studies mainly focused on the effects of backpack type, weight and position on their muscle activity; and the main muscles studied were upper trapezius, erector spinae, and rectus abdominis, while the studies on other muscles were still insufficient. Conclusion: Backpack type and method, backpack weight, backpack strap design, backpack position, and backpack time all have different effects on muscle activity in various parts of the adolescent body, and these effects may lead to back pain, which is one of the factors affecting spinal health that cannot be ignored.