Municipal sludge is characterized by high organic matter content, high viscosity, and fine particles, resulting in poor dewatering performance. This article analyzes the composition and properties of municipal sludge, examines the factors affecting the dewatering performance of sludge and the mechanisms corresponding to each influencing factor, and introduces chemical conditioning in detail. Chemical conditioning includes flocculation conditioning, oxidation conditioning, acid-base conditioning, and aggregate conditioning. The principles and applications of existing sludge conditioning technologies are systematically analyzed. By comparing the advantages and disadvantages of different technologies, it is pointed out that the key to developing sludge conditioning technology lies in developing a more appropriate combination of the sludge conditioning and dewatering process according to the sludge quality of different municipal wastewater treatment plants, taking into account their local environment, input costs, subsequent sludge disposal methods, and other factors, and further optimizing the sludge dewatering process by developing new efficient and environmentally friendly sludge conditioning agents.