Real-time visualization of tumor boundaries and occult lesions is essential for precision surgery. However, conventional imaging struggles to meet intraoperative navigation demands. Second near-infrared region (NIR-II, 1000-1700 nm) fluorescence imaging enables high precision surgical navigation through low scattering effect, high sensitivity, spatial resolution, and real-time capability. Recent innovations in probes, methods, and systems accelerate NIR-II clinical translation. Targeted probes enhance tumor specificity, tomography reconstruction and deep learning enable 3D lesion localization and pathological correlation, open and endoscopic systems support diverse surgical scenarios. Preliminary clinical studies demonstrate significant value for intraoperative tumor imaging and neurovascular preservation. This paper reviews the technological evolution and clinical transformation challenges of NIR-II surgical navigation, focuses on the development status and technical difficulties of imaging probes, methods, systems and clinical applications, and proposes the future development direction of interdisciplinary collaborative promotion of high-sensitivity imaging probes, tumor imaging and quantitative analysis methods, and the intelligent surgical navigation system, in order to improve the clinical transformation speed and application potential of fluorescent surgical navigation technology.