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Rare earth, with the reputation of “industrial vitamins”, has become a strategic key metal for industrial powers with increasingly significant industrial application value. As a unique rare earth resource, ionic rare earth ore (IREO) has the outstanding advantages of complete composition, rich resource reserves, low radioactivity, and high comprehensive utilization value. IREO is the main source of medium and heavy rare earth raw materials, which are in great demand all over the world. Since the discovery of IREO, it has attracted extensive attention. Scientists in China and the around world have carried out a lot of research and practical work and achieved a series of important breakthroughs. This paper introduces the discovery process, metallogenic causes, deposit characteristics, and the prospecting research progress of IREO, so as to deepen the understanding of the global distribution of ionic rare earth resources and the prospecting direction of ionic rare earth deposits. The leaching principle of IREO, the innovation of leaching process, the influencing factors and technological development of in situ leaching process, and the technical adaptability of in situ leaching process are reviewed. The development of leachate purification and rare earth extraction technology is summarized. We aim to provide guidance for the industrial development of IREO through the above review analysis. Additionally, the problems existing in the development of IREO are pointed out from the aspects of technology, economy, and the environment. Ultimately, a series of suggestions are put forward, such as the development of ammonium free extraction technology in the whole exploitation process of in situ leaching and leachate purification and rare earth precipitation, research on enhancing of seepage and mass transfer process, and research on the development of new technologies for impurity removal of leachate and extraction of rare earth, so as to promote the development of green and efficient exploitation new technologies and sustainable development of ionic rare earth ore.