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Carbon-bearing gold ore is one of the important refractory gold resources, which can not be effectively utilized by conventional treatment methods. In this paper, the main reasons for the difficult treatment of carbon-containing gold ore, the material composition of carbonaceous matter and the mechanism of carbonaceous matter “robbing gold” are analyzed. At the same time, the working principles of several pretreatment methods are summarized, and the advantages and disadvantages of each pretreatment method are analyzed, so as to provide strong technical support for the future development of carbon-bearing gold ores in China.