Alarmins are a class of molecules released when affected cells damaged or undergo apoptosis. They contain various chemotactic and immunomodulatory proteins or peptides. These molecules regulate the immune response by interacting with pattern recognition receptors (PRRs) and play important roles in inflammatory response, tissue repair, infection defense, and cancer treatment. Spontaneous abortion (SA) is a common pregnancy-related disease, and its pathogenesis has been puzzling clinicians, so it needs to be further studied. In this paper, we first reviewed the research status of various alarmins and SA, focusing on the role of high mobility box 1 (HMGB1), interleukin33 (IL-33), interleukin1β (IL-1β) and S-100 protein (S100 protein) in immune response, inflammation, embryonic development and abortion. Subsequently, this paper summarized the effect of alarmins on pregnancy outcome by influencing angiogenesis-related factors. Finally, from the perspective of aseptic inflammation, the pro-inflammatory signaling pathways involved in various alarmins and their targeted drugs were reviewed. By focusing on specific molecules in alarmins and their receptors and signaling pathways, we can more accurately conduct drug research and development. The purpose of this review is to explore the role of alarmins in SA, and provide important references for early detection of abortion risk, revealing the disease mechanism, developing new therapies and improving the prognosis of patients.