Cranial bone marrow (CBM) is a research hotspot at the intersection of neuroscience and immunology. Endowed with unique structural features (e.g., lifelong plastic blood vessels, skull-dural microchannels, and periosteum-specific lymphatic vessels) and molecular phenotypes (anti-aging hematopoietic microenvironment, immune cells with anti-inflammatory phenotypes), CBM serves as a critical hematopoietic and immune reservoir adjacent to the central nervous system (CNS). CBM regulates CNS homeostasis through dual functions of hematopoiesis support and immune surveillance, playing important roles in stroke, meningitis, brain tumors, etc. Its microchannels also act as a potential drug delivery route bypassing the blood-brain barrier. The "CBM-dura mater-glymphatic system" forms the core regulatory axis of CNS homeostasis. In the future, it is necessary to focus on the internal coordination mechanism of the regulatory axis, the regulation of microchannel opening, non-invasive human imaging and tracing technologies of skull and dura mater microchannels, the clinical transformation and application of key regulatory targets and microchannel drug delivery technologies, and 3D microchannel reconstruction after skull defect, so as to provide new breakthroughs for the precise diagnosis and treatment of CNS diseases.