Due to the occurrence of strong biogeochemical processes in the lateral hyporheic zone (LHZ), its unique and complex hydrodynamic characteristics play an important role in aquatic ecosystem and ecological environment. Through analysis and summarization of previous studies on the LHZ, the process and mechanism of hyporheic exchange in different directions are clarified, and the main factors (including topographic conditions, characteristics of sedimentary layers, hydrogeological conditions, river engineerings, and riparian vegetation conditions) that affect the lateral hyporheic exchange are analyzed in detail. Furthermore, the effects of lateral hyporheic exchange on solutes, grains, and ecological environments are discussed. Finally, some suggestions on this subject are given for future study.