Powder metallurgy niobium alloys, which are characterized by their homogeneous microstructure, fine-grained structure, and superior mechanical properties, serve as critical high-temperature structural materials in the aerospace, defense, and nuclear industries. This paper systematically reviews recent advances in the preparation of niobium alloy powders, forming and sintering densification processes, additive manufacturing techniques, and microstructure-property optimization. Special emphasis is placed on state-of-the-art powder preparation technologies, including the hydrogenation-dehydrogenation process, plasma rotating electrode process, electrode induction gas atomization, electron beam atomization, and near-spherical powder modification techniques. Furthermore, an in-depth analysis of current developments in forming and densification methods such as metal injection molding, hot isostatic pressing, field-assisted sintering technology, and additive manufacturing is provided. By comparing the mechanical properties of powder metallurgy niobium alloys under diverse alloy systems and processing routes, this study elucidates the intrinsic relationships among processing parameters, microstructure evolution, and performance outcomes. Finally, future research directions are proposed, encompassing cost-effective high-efficiency powder synthesis, novel strategies for strength-toughness synergy, optimization of binder-assisted 3D printing processes, and breakthroughs in manufacturing technologies for high-performance complex components.