Patients with rare diseases often experience prolonged disease courses, complex clinical manifestations and the need for long-term treatment. As a result, family caregivers are required to continuously undertake multiple responsibilities, including dis- ease management, daily care and psychological support. Therefore, they commonly experience various burdens related to physical health, psychological well-being, socioeconomic status and information and decision-making. The burden on caregivers is influenced by a variety of factors, including the characteristics of the patient's disease, the caregiver's own factors, family and social support, medi- cal resources and disease management. These influences in turn affect the quality of care and disease outcomes for patients. This article reviews the main manifestations, influencing factors, and nursing intervention strategies of the caregiver burden for patients with rare diseases. It focuses on nursing approaches such as strengthening caregiver assessment and health education, providing psychological support and caregiver empowerment, improving continuing care and multidisciplinary collaboration as well as building a family-commu- nity-social support system. We aims to provide references for clinical nursing practice and related research, thereby promoting improve- ments in the quality of life of both patients and their caregivers.