The invention discloses a medical instrument pairing method and platform, a server and gateway equipment, and the method comprises the steps: firstly receiving a pairing request, transmitted by the gateway equipment, of a medical instrument, judging whether the medical instrument currently has a pairing relation or not according to the pairing request, updating the pairing relation if the medicalinstrument currently has the pairing relation, and otherwise updating the pairing relation; and if not, creating a new pairing relationship, and sending a pairing success response to the gateway device after pairing. The gateway devices can be in one-to-one correspondence with the users, when the medical instruments have the pairing relationship, it is indicated that the medical instruments are paired with other users, and at the moment, the pairing relationship is updated according to the pairing request, so that the medical instruments uniquely correspond to the users corresponding to the gateway devices, and therefore, the workload of manual pairing can be eliminated for medical personnel; and the error probability of medical staff is reduced. Moreover, automatic pairing can be realized, and the operation difficulty of the user is reduced.