Enhanced recovery after surgery (ERAS) significantly improves patient outcomes by optimizing perioperative management strategies. As a core component of ERAS, multimodal analgesia (MMA) integrates analgesic agents and techniques with different mechanisms of action to achieve effective postoperative pain control while reducing opioid consumption and opioid-related adverse effects. This article systematically reviews the specific applications and clinical value of MMA across various surgical specialties, including abdominal, orthopedic, and thoracic surgeries. Current challenges—such as insufficiently individualized analgesic strategies and uneven implementation of advanced techniques—are analyzed, and future directions based on precision medicine, novel analgesic agents, and intelligent technologies are discussed. Clinical practice demonstrates that MMA facilitates early postoperative recovery through optimized analgesic regimens and represents critical foundation for the successful implementation of ERAS.