Background: Long-distance swimmers exert energetic, physiological, and neuromuscular demands that must be matched with adequate body composition to improve their performance in long-distance swimming. Objectives: This review aims to compile all available information on energetic and physiological demands, optimal body composition, nutrition, and ergogenic supplements in long-distance swimming. This will provide an understanding of the specific challenges and needs of this sport and will help swimmers and coaches design more effective training and nutrition plans to optimise performance and achieve their goals. Methods: Databases such as Web of Science, SciELO Citation Index, MEDLINE (PubMed), Current Contents Connect, KCI-Korean Journal Database, and Scopus were searched for publications in English using keywords such as swimming, endurance, energy demands, physiological demands, nutrition, body composition, and ergogenic aids, individually or in combination. Results: There is convincing evidence that several physical indicators, such as propulsive surface area, technical, such as stroke rate, and functional, such as hydration strategies, are related to swimming performance and body composition. Each athlete may have a specific optimal body fat level that is associated with improved sporting performance. The nutritional needs of open water swimmers during competition are quite different from those of pool swimmers. Conclusions: Swimmers with an adequate physique have a high body muscle mass and moderately related anaerobic strength both on land and in the water. These general and specific strength capacities, which are given by certain anthropometric and physiological characteristics, are seen throughout the work, as well as ergogenic and nutritional strategies, which have an important impact on long-distance swimming performance.