With the development of high-power fuel cell vehicles, heat dissipation requirements have become increasingly stringent. Although conventional cooling techniques improve the heat dissipation capacity by increasing the fan rotating speed or radiator dimensions, high energy consumption and limited engine compartment space prevent their implementation. Moreover, the insufficient heat transfer capacity of existing coolants limits the enhancement of heat dissipation performance. Therefore, exploring novel coolants to replace traditional coolants is important. Nanofluids composed of nanoparticles and base liquids are promising alternatives, effectively improving the heat transfer capacity of the base liquid. However, challenges remain that prevent their use in fuel cell vehicles. These include issues regarding the nanofluid stability and cleaning, erosion and abrasion, thermal conductivity, and electrical conductivity. In this review, we summarize the nanofluid applications in oil-fueled, electric, and fuel cell vehicles. Subsequently, we provide a comprehensive literature review of the challenges and future research directions of nanofluids as coolants in fuel cell vehicles. This review demonstrates the potential of nanofluids as an alternative thermal management system that can facilitate transition toward a low-carbon, energy-secure economy. It will serve as a reference for researchers to focus on new areas that could drive the field forward.