Abstract: In the context of the national "dual carbon" target, the microalgal-bacterial consortium (MBC) system has emerged as a promising wastewater treatment technology. Leveraging its distinctive advantages in low-carbon resource recovery and high-value biomass production, MBC is increasingly becoming a focal point of research in the wastewater treatment sector. By harnessing these interactions between microalgae and bacteria, MBC collaboratively targets pollutants in wastewater, converting them into renewable energy and valuable biomass products, thereby fulfilling the dual objectives of wastewater treatment and resource recovery. This process not only aligns with these principles of green and environmentally friendly development but also provides a viable technological pathway for sustainable development. However, despite these notable benefits of MBC technology in wastewater treatment and resource recovery, its practical application encounters several challenges. The physicochemical properties and biological activities of MBC are affected by various factors, particularly fluctuations in wastewater quality and changes in environmental conditions such as temperature, light intensity, and pH levels. These factors can result in instability in the treatment performance of MBC systems, thereby restricting the widespread adoption and practical efficacy of this technology on a large scale. Consequently, it is essential to thoroughly investigate and understand the symbiotic mechanisms among microorganisms within the MBC system, as well as the influence of external environmental factors on its system performance. To enhance the efficiency and stability of MBC systems, this review conducts a comparative analysis of the fundamental principles, cultivation methods, and operational characteristics of MBC and indigenous MBC technologies. It explores the interaction patterns between microalgae and bacteria and examines the mechanisms by which ecological factors impact system operations. Furthermore, this review summarizes the prevalent system models of current MBC systems, discussing the advantages and disadvantages of different models and their suitability. In terms of engineering applications, this review provides a comprehensive review of the research advancements in MBC wastewater treatment technology, focusing on the achievements and challenges of MBC technology in pilot and full-scale applications worldwide. By comparing application cases from various countries and regions, this review identifies the technical bottlenecks faced by MBC technology in practical operations and explores the key technical issues that need to be overcome in the future. Finally, the review anticipates the future research directions and application prospects of MBC technology, highlighting the necessity and feasibility of further promoting the large-scale application of this technology. This review offers a thorough analysis of the current status and future potential of MBC systems in sustainable wastewater treatment, providing theoretical support for the practical application of MBC.