Lactylation plays an important regulatory role in neural development, neural stem cell fate determination, and the physiological function of the nervous system. Abnormal lactylation is closely related to the occurrence and development of hippocampal microglial inflammation in post-traumatic stress disorder (PTSD), so lactylation may serve as a potential therapeutic target for PTSD. This article reviewed the latest research progress on the involvement of lactylation in hippocampal microglial inflammation and its molecular mechanisms in PTSD.