The underground hydropower projects in Southwest China is characterized by large excavation sizes, high geostresses, complicated geological conditions and multiple construction processes. Various disasters such as collapses, large deformations, rockbursts are frequently encountered, resulting in serious casualties and huge economic losses. This review mainly presents some representative results on microseismic (MS) monitoring and forecasting for disasters in hydropower underground engineering. First, a set of new denoising, spectral analysis, and location methods were developed for better identification and location of MS signals. Then, the tempo-spatial characteristics of MS events were analyzed to understand the relationship between field construction and damages of surrounding rocks. Combined with field construction, geological data, numerical simulation and parametric analysis of MS sources, the focal mechanism of MS events was revealed. A damage constitutive model considering MS fracturing size was put forward and feedback analysis considering the MS damage of underground surrounding rocks was conducted. Next, an MS multi-parameter based risk assessment and early warning method for dynamic disasters were proposed. The technology for control of the damage and deformation of underground surrounding rocks was proposed for underground caverns. Finally, two typical underground powerhouses were selected as case studies. These achievements can provide significant references for prevention and control of dynamic disasters for underground engineering with similar complicated geological conditions.