Randomized controlled trials (RCT) are the gold standard for evaluating the effectiveness of medical interventions, and the quality of their reporting is critical to clinical practice and scientific research. Consolidated standards of reporting trials (CONSORT) statements and their extended tools are the core standards for reporting quality of RCT. Since its first publication in 1996, it has been updated and expanded several times, and has become the authoritative guideline in the field of clinical research worldwide. This paper systematically reviews the evolution of CONSORT from its foundation version in 1996 to the latest version in 2025, and analyzes the classification and application scenarios of five categories of CONSORT extension tools (research design/analysis type oriented, subject domain oriented, reporting process-oriented, research focus oriented, and interdisciplinary integration oriented) in detail. CONSORT has significantly improved the transparency, reproducibility, and scientific rigor of RCT reporting, especially in reducing the risk of bias, standardizing data sharing, and promoting open science. However, its implementation still faces challenges such as concept misuse, insufficient cross-cultural adaptation, resource limitation, and mechanization. The CONSORT system needs to be promoted into high-quality practice worldwide through the development of multilingual resources, the application of intelligent tools and international cooperation, so as to provide continuous support for the standardization and evidence transformation of clinical research.