Mo-Si-B alloys are a crucial focus for the development of the next generation of ultra-high-temperature structural materials. They have garnered significant attention over the past few decades due to their high melting point and superior strength and oxidation resistance compared to other refractory metal alloys. However, their low fracture toughness at room temperature and poor oxidation resistance at medium temperature are significant barriers limiting the processing and application of Mo-Si-B alloys. Therefore, this review was carried out to compare the effectiveness of doped metallic elements and second-phase particles in solving these problems in detail, in order to provide clear approaches to future research work on Mo-Si-B alloys. It was found that metal doping can enhance the properties of the alloys in several ways. However, their impact on oxidation resistance and fracture toughness at room temperature is limited. Apart from B-rich particles, which significantly improve the high-temperature oxidation resistance of the alloy, the doping of second-phase particles primarily enhances the mechanical properties of the alloys. Additionally, the application of additive manufacturing to Mo-Si-B alloys was discussed, with the observation of high crack density in the alloys prepared using this method. As a result, we suggest a future research direction and the preparation process of oscillatory sintering, which is expected to reduce the porosity of Mo-Si-B alloys, thereby addressing the noted issues.