Titanium and titanium alloys have important applications in high-end manufacturing fields such as aerospace, marine vessel and automobile industries because of their excellent specific strength, corrosion resistance and high-temperature properties. Titanium casting processes are restricted by characteristics such as a high melting point and high reactivity. In recent years, significant progress has been made in titanium alloy casting technology, including investment casting, graphite casting, sand casting, rapid casting, counter-gravity casting and other processes. In addition, the application of numerical simulation and hot isostatic pressure (HIP) technology provides important guarantees for the performance optimization and quality improvement of titanium alloy castings. This paper provides a comprehensive review of the significant advancements in titanium alloy casting research over recent years. It examines the advantages and limitations associated with various casting processes while also highlighting the current research frontiers, as well as the opportunities and challenges that exist within the field of titanium alloy casting.