The discharge of aquaculture wastewater, comprising nitrogen, phosphorus, heavy metals, and antibiotics from large-scale aquaculture, poses a significant threat to marine ecosystems and human health. Consequently, addressing the treatment of marine aquaculture wastewater is imperative. Conventional physicochemical treatment methods have various limitations, whereas microalgae-based biological treatment technologies have gained increasing attention in the field of water purification due to their ability to efficiently absorb organic matter from mariculture wastewater and convert CO₂ into biomass products. Microalgae offer potential for highly efficient and cost-effective mariculture wastewater treatment, with particularly noteworthy advancements in the application of combined microalgae technologies. This paper explores the research hotspots in this field through bibliometric analysis and systematically discusses the following aspects: (1) summarizing the current pollution status of mariculture wastewater, including the types and sources of pollutants in various forms of mariculture wastewater, treatment methods, and associated treatment efficiencies; (2) analyzing the factors contributing to the gradual replacement of single microalgae technology with combined microalgae technology, highlighting its synergistic effects, enhanced pollutant removal efficiencies, resource recovery potential, and alignment with sustainable development goals; (3) exploring the mechanisms of pollutant removal by combined microalgae technologies, focusing on their technical advantages in bacterial-algal coupling, immobilized microalgae systems, and microalgal biofilm technologies; (4) discussing the challenges faced by the three main categories of combined microalgae technologies and proposing future improvement strategies to further enhance their application effectiveness. In conclusion, this paper offers a detailed analysis of these emerging technologies, providing a forward-looking perspective on the future development of microalgae-based mariculture wastewater treatment solutions.