Mg-based materials have been widely studied as potential hydrogen storage media due to their high theoretical hydrogen capacity, low cost, and abundant reserves. However, the sluggish hydrogen absorption/desorption kinetics and high thermodynamic stability of Mg-based hydrides have hindered their practical application. Ball milling has emerged as a versatile and effective technique to synthesize and modify nanostructured Mg-based hydrides with enhanced hydrogen storage properties. This review provides a comprehensive summary of the state-of-the-art progress in the ball milling of Mg-based hydrogen storage materials. The synthesis mechanisms, microstructural evolution, and hydrogen storage properties of nanocrystalline and amorphous Mg-based hydrides prepared via ball milling are systematically reviewed. The effects of various catalytic additives, including transition metals, metal oxides, carbon materials, and metal halides, on the kinetics and thermodynamics of Mg-based hydrides are discussed in detail. Furthermore, the strategies for synthesizing nanocomposite Mg-based hydrides via ball milling with other hydrides, MOFs, and carbon scaffolds are highlighted, with an emphasis on the importance of nanoconfinement and interfacial effects. Finally, the challenges and future perspectives of ball-milled Mg-based hydrides for practical on-board hydrogen storage applications are outlined. This review aims to provide valuable insights and guidance for the development of advanced Mg-based hydrogen storage materials with superior performance.