This article extensively reviews published research on inclusions in ingot steel and defects on ingot products, methods to measure and detect inclusions in steel, the causes of exogenous inclusions, and the transport and entrapment of inclusions during fluid flow, segregation, and solidification of steel cast in ingot molds. Exogenous inclusions in ingots originate mainly from reoxidation of the molten steel, slag entrapment, and lining erosion, which are detailed in this article. The measures to prevent the formation of exogenous inclusions and improve their removal are provided, which are very useful for the clean steel production of ingot industries.