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Psoriasis, a systemic immune-inflammatory disease, is often associated with metabolic syndromes such as obesity. As the most classical pro-inflammatory adipokine, leptin has received persistent attention in psoriasis. Currently, it is generally believed that leptin promotes the development of psoriasis. This article delves into the intricate relationship between leptin and the development of psoriasis, along with its associated metabolic complications. Additionally, the potential mechanisms by which leptin operates in the pathological processes of psoriasis, such as immune inflammatory activation, epidermal keratinocyte proliferation, differentiation and secretion of proinflammatory factors, and proliferation and dilatation of dermal papillary capillaries, are explored.