Objective  To explore the clinical value of second polar body (Pb2) exclusion monitoring by time-lapse in predicting the fertilization and embryo development efficiency for intracytoplasmic sperm injection (ICSI).     Methods  A retrospective research was performed on 278 patients treated with ICSI, the clinical data and Time-lapse monitoring embryo culture data were collected and analyzed, to explore the exclusion of Pb2 after ICSI and the relationship between the specific exclusion time and the outcome of fertilization and embryo development.     Results  The average time of Pb2 exclusion after ICSI was (3.03 ± 1.21) hours; The fertilization rate, 2 pronucleus(PN) fertilization rate and 5 days(D5) blastocyst formation rate in the Pb2 exclusion group were significantly higher than those in the without Pb2 exclusion group (99.95% vs 1.75%, P<0.001; 97.18% vs 0.66%, P<0.001; 60.50% vs 16.67%, P<0.05); The 2PN fertilization rate in Pb2 exclusion time >3-4 hours group was significantly higher than that in 0-2 hours group and >5 hours group (98.80% vs 93.81%, P<0.05; 98.80% vs 95.40%, P<0.05); The exclusion time of Pb2 was significantly correlated with the average number of blastomeres in D3 embryos (P<0.001). The D5 blastocyst formation rate of 3-4 hours group was significantly lower than that of >2-3 hours group (56.23% vs 67.23%, P<0.05), >4-5 hours group was significantly lower than 0-2 hours group and >2-3 hours group (46.61% vs 62.30%,  P<0.05; 46.61% vs 67.23%,  P<0.05), and D5 blastocyst formation rate of >5 hours group was 7.14%, which were significantly lower than that of the other four groups ( P<0.05). The formation rate of D5 high-quality blastocysts in 3-4 hours group was significantly lower than 0-2 hours group and > 2-3 hours group (9.92% vs 16.39%,  P<0.05; 9.92% vs 20.72%,  P<0.05), and D5 high-quality blastocysts formation rate in > 4-5 hours group was significantly lower than that in > 2-3 hours group (11.02% vs 20.72%,  P<0.05).     Conclusion  Monitoring Pb2 exclusion by Time-lapse can accurately predict fertilization outcome. The time of Pb2 exclusion is significantly correlated with embryo development potential. It is a valuable morphological index to predict fertilization and embryo development outcome in ICSI.