Etomidate is a widely utilized anaesthetic agent for the induction of general anesthesia, recognized for its rapid onset and minimal hemodynamic suppression effects. However, its clinical application is constrained by several adverse effects, including adrenal cortex suppression, postoperative nausea and vomiting, and myoclonus. In recent years, there has been a growing global research focus on structural modifications of the etomidate molecule, aiming to simultaneously ameliorate its adverse effects and optimize its hemodynamic stability efficacy. These concerted research efforts have led to the successful synthesis and characterization of numerous etomidate analogs with improved pharmacological profiles. This comprehensive review systematically examines recent scientific advancements in this field, focusing on structural modifications, pharmacological properties, and clinical translation of these novel compounds.