The transverse discrepancy is one of the core issues of three-dimensional occlusal abnormalities, mainly manifested as the disharmony of the width of the maxillary and mandibular dental arches and basal bones. Especially maxillary transverse deficiency is a common problem in clinical practice. The diagnosis of transverse problems is crucial for the selection of treatment timing, the formulation of treatment plans, and the stability of orthodontic results. Compared with sagittal and vertical problems, the diagnostic criteria for transverse problems have not been unified, which affects the scientificity and consistency of treatment decisions. This article aims to systematically review and analyze the current status of the diagnosis of transverse problems in patients with malocclusion, covering traditional diagnostic methods, emerging digital technologies, the application prospects of artificial intelligence, as well as the challenges and progress in standardization.