High-carbon steel wires used for bridge cables, tire reinforcement materials and cutting materials of silicon ingot for photovoltaic industry require an extremely fine diameter and high strength. Poor control of centerline segregation, inclusion and microstructure of high-carbon steel is detrimental to drawability and subsequent fatigue performance. Prof. Weiqing Chen’s group at the University of Science and Technology Beijing (USTB) has been investigating the quality control of high-carbon steel through a low-cost one-stage hot rolling process since 2000. This paper reviews the main research from this group. The laboratory-scale and industrial results are presented. Intensive secondary cooling, final electromagnetic stirring (F-EMS), final permanent magnetic stirring (F-PMS), and soft reduction are investigated and applied to control centerline segregation, and the application scope is also discussed. A combination of redesign of submerged entry nozzle (SEN) and refining slag, utilization of Al-free refractory and the addition of low-melting-point compounds is studied and applied effectively to control inclusions. Measurements and mechanisms to control network cementite, martensite, banded structure and undesired texture are investigated and discussed. Integration of the above research has achieved industrial application in more than 10 steelworks and was further extended to application in spring steel, welding wire steel and some other wire rods.