The groundwater table fluctuation (GTF) zone is an important medium for the hydrologic cycle between unsaturated soil and saturated aquifers, which accelerates the migration, transformation, and redistribution of contaminants and further poses a potential environmental risk to humans. In this review, we clarify the key processes in the generation of the GTF zone and examine its links with the variation of the hydrodynamic and hydrochemistry field, colloid mobilization, and contaminant migration and transformation. Driven by groundwater recharge and discharge, GTF regulates water flow and the movement of the capillary fringe, which further control the advection and dispersion of contaminants in soil and groundwater. In addition, the formation and variation of the reactive oxygen species (ROS) waterfall are impacted by GTF. The changing ROS components partially determine the characteristic transformation of solutes and the dynamic redistribution of the microbial population. GTF facilitates the migration and transformation of contaminants (such as nitrogen, heavy metals, non-aqueous phase liquids, and volatile organic compounds) through colloid mobilization, the co-migration effect, and variation of the hydrodynamic and hydrochemistry fields. In conclusion, this review illustrates the limitations of the current literature on GTF, and the significance of GTF zones in the underground environment is underscored by expounding on the future directions and prospects.