Mesoporous silica SBA-15 has emerged as a promising adsorbent and separation material due to its unique structural and physicochemical properties. To further enhance its performance, various surface modification strategies, including metal oxide and noble metal incorporation for improved catalytic activity and stability, organic functionalization with amino and thiol groups for enhanced adsorption capacity and selectivity, and inorganic-organic composite modification for synergistic effects, have been extensively explored. This review provides a comprehensive overview of the recent advances in the surface modification of SBA-15 for adsorption and separation applications. The synthesis methods, structural properties, and advantages of SBA-15 are discussed, followed by a detailed analysis of the different modification strategies and their structure-performance relationships. The adsorption and separation performance of functionalized SBA-15 materials in the removal of organic pollutants, heavy metal ions, gases, and biomolecules, as well as in chromatographic and solid-liquid separation, is critically evaluated. Despite the significant progress, challenges and opportunities for future research are identified, including the development of low-cost and sustainable synthesis routes, rational design of SBA-15-based materials with tailored properties, and integration into practical applications. This review aims to guide future research efforts in developing advanced SBA-15-based materials for sustainable environmental and industrial applications, with an emphasis on green and scalable modification strategies.