Osteomyelitis is a major complication of orthopedic diseases with high recurrence and morbidity, along with long hospital stays and high medical costs. The conventional treatment of osteomyelitis involves surgical debridement followed by long-term and high-dose of systemic antibiotic therapy, which in many cases is not effective and can induces serious bacterial resistance. As an alternative strategy, local therapy has been devel-oped for treatment of osteomyelitis. In this review, we expound on the advances in the antimicrobial treatment of osteomyelitis including antimicrobial agent therapy, physical therapy and immunotherapy, which we hope to shed some light on future research of osteomyelitis treatment.