As the application of bone scaffolds becomes more and more widespread, the requirements for the high performance of bone scaffolds are also increasing. The stiffness and porosity of porous structures can be adjusted as needed, making them good candidates for repairing damaged bone tissues. However, the development of porous bone structures is limited by traditional manufacturing methods. Today, the development of additive manufacturing technology has made it very convenient to manufacture bionic porous bone structures as needed. In the present paper, the current state-of-the-art optimization techniques for designing the scaffolds and the settings of different optimization methods are introduced. Additionally, various design methods for bone scaffolds are reviewed. Furthermore, the challenges in designing high performance bone scaffolds and the future developments of bone scaffolds are also presented.