The generation of high-salinity wastewater is closely associated with various industries, containing a plethora of dissolved salts such as chlorides, sulfates, and carbonates, which pose a significant threat to the environment and human health. Consequently, the treatment of high-salinity wastewater has emerged as a pivotal environmental challenge in contemporary society. This review aims to elucidate the sources and characteristics of high-salinity wastewater, as well as the current status and trends in the field of high-salinity wastewater treatment. First and foremost, we explore the means by which high-salinity wastewater is generated in different industries and the principal salt components it contains. We revisit conventional methods for high-salinity wastewater treatment, including chemical precipitation, ion exchange, evaporation-crystallization, and reverse osmosis, while emphasizing the application of biotechnological approaches. This includes the utilization of salt-tolerant microorganisms, biological adsorption, biodegradation processes, and various types of bioreactors. Advanced oxidation technologies also play a crucial role in high-salinity wastewater treatment. We introduce advanced oxidation techniques such as ozone oxidation, UV-catalyzed oxidation, and high-pressure water oxidation, emphasizing their potential in degrading organic compounds and reducing salt concentration. Furthermore, we discuss hybrid approaches, such as case studies combining biological treatment with advanced oxidation technologies, and the advantages and challenges associated with these integrated techniques. Finally, we provide an outlook on future trends, including research on novel and efficient biodegrading agents, advancements and innovations in advanced oxidation technologies, and the development of intelligent high-salinity wastewater treatment systems. Policy and industry trends will also influence the direction of high-salinity wastewater treatment field development. In summary, high-salinity wastewater treatment represents a complex and pressing environmental challenge. However, through the integration of diverse treatment technologies and ongoing research efforts, it is anticipated that more effective, cost-efficient, and environmentally friendly solutions can be developed to mitigate the impact of high-salinity wastewater on ecosystems and society.