Myopia is the most common eye disorder worldwide. So far there is no effective treatment for the disease. Recent findings indicated that the remodeling of scleral extracellular matrix (ECM) plays an important role in the development of myopia. The dynamic changes of matrix metalloproteinases in myopia (MMPs) activity, one of the most important enzymes that regulates the ECM, has a significant correlation with myopia. This review gives the latest findings about ECM and MMPs in the development of myopia.