Oil and gas pipelines in permafrost regions differ greatly from those in temperate climate zones. People only know that these pipelines were constructed in remote areas with fragile environments. However, gas pipeline engineering, construction, operation and management will face a series of unique problems because of unforgiving environment, special hydrogeology, engineering geology, and freezing and thawing disasters. Being different from the Trans-Alaska Pipeline System, Roman Wells Oil Pipeline, China-Russia Crude Oil Pipeline from Mo’he to Daqing and Golmud-Lhasa Oil Products Pipeline, natural gas pipelines in permafrost regions face new problems and challenges in many areas including different transporting media, gas flow temperature control and environmental protection. This paper systematically reviewed issues such as chilled transporting processes, coupled hydrothermal-hydraulic-mechanical modeling of the pipe-soil system, temperature overrun in station outage scenarios, engineering constraints of stress-based design, single laying method and low reliability of monitoring system during operating stage. Initial framework solutions were proposed in the hope of identifying new approaches for gas pipeline in northern and upland permafrost regions.