Cold expansion technology has been widely used in aviation industries as an effective method of improving the fatigue performance of fastener holes. It can improve the fatigue life several times over without adding weight, meeting the growing demand for lightweight and durable aircraft structures. In recent years, it has been extensively studied through extensive experiments and finite element simulations to analyze the residual stresses around the fastener hole. Appropriate process parameters lead to the generation of beneficial residual stresses that influence the material microstructure, thereby improving the fatigue life of the component. This paper summarized factors influencing residual stresses in cold expansion and their effects on fatigue life, and the strengthening mechanism, parameter optimization, and effect of anti-fatigue are discussed from the point of view of the residual stress and microstructure. The development of new cold expansion technologies and the research directions that can realize anti-fatigue technology efficiently are proposed.