Print mottle is a serious and common uneven printing defect that occurs when printing coated paper by the offset multicolor printing process. It is characterized by a non-uniform appearance in terms of brightness, gloss, or color density that appears mostly in solid printed areas. Back-trap print mottle and water-interference print mottle occur when the quality of the paper substrate, especially the coating layer quality, is not satisfactory. To cope with this quality problem of coated papers, the understanding of the offset printing process, the requirements of coated-paper quality, and the reasons for this problem should be addressed. In this review, the basic process of offset printing and the mechanisms of print mottles were explored, the importance of coating uniformity in both the coating structure and process was reviewed, and the approaches to cope with print mottle were introduced.