Starfish are keystone species as predators in benthic ecosystems, but when population outbreaks occur, this can have devastating consequences ecologically. Furthermore, starfish outbreaks and invasions can have adverse impact economically by impacting shellfish aquaculture. For example, an infestation of starfish in Qingdao led to a 50% reduction in sea cucumber production and an 80% reduction in scallop production, resulting in an economic loss of approximately RMB 100 million to oyster and other shellfish industries. Addressing the imperative need to proactively mitigate starfish invasions requires comprehensive research on their behavior and the underlying mechanisms of outbreaks. This review scrutinizes the historical patterns of outbreaks among diverse starfish species across various regions, delineates the factors contributing to the proliferation of Asterias amurensis in Chinese waters, articulates preventive and remedial strategies, and outlines the potential for the sustainable utilization of starfish.