Ocular ischemic syndrome (OIS) is defined as ocular ischemia and hypoxia secondary to chronic hypoperfusion of the ocular arteries, chiefly caused by internal carotid artery stenosis or occlusion. The pathophysiological evolution of OIS manifests as a dynamic continuum, including prodromal, retinopathic, and neovascular phases. However, due to the often insidious and non-specific clinical presentations during the prodromal and retinal ischemic stages, they are frequently overlooked in clinical practice. Consequently, current interventional strategies are predominantly focused on the neovascular stage, particularly on managing its complications such as neovascular glaucoma. Management strategies also remain inconsistent among physicians of different specialties. Consequently, there is a pressing need to formulate and implement a clinical consensus on OIS that aligns with the specific context of medical practice in China. The formulation of this consensus involved a structured literature retrieval and an analysis of multidisciplinary diagnostic and therapeutic experiences worldwide, consolidated with China's clinical practices to produce the initial draft. Following critical appraisal and successive revisions by a core panel of experts, the final version was established. This consensus encompasses all aspects of OIS clinical care, including its epidemiology, anatomical basis, pathogenesis, risk factors, clinical manifestations, auxiliary examinations, diagnosis, staging, differential diagnosis, and therapeutic interventions (comprising ocular, pharmacological, surgical, and physical treatments). It also evaluates associated vascular event risks (including stroke, cerebral small vessel disease, myocardial ischemia, and mortality) and provides recommendations on patient follow-up and systematic management, with the principal objective of improving the integrated diagnostic and therapeutic standards for OIS throughout China. Given variations in patient profiles and differences in healthcare resources across medical institutions, clinicians should adapt the recommendations in this consensus to individual circumstances. In the management of OIS, a patient-centered approach should always be maintained, with individualized treatment plans implemented to maximize visual function improvement and reduce the risk of neovascular glaucoma and vascular events.