Iron ore granulation is an indispensable process in the production of sinter that can influence and regulate the yield, efficiency and quality. Although a great deal of research has been done on the granulation process over the past decades, we still need to think about the current and future development of this process, as sinter is still an essential raw material for ironmaking blast furnace today. This paper begins with a review of particle agglomeration theory development for sintering granulation, followed by a summary of existing granulation evaluation methods and indexes. The roles of iron ore, fuel, fluxes, and moisture in sintering granulation are also analyzed, and finally advanced granulation equipment and processes for industrial production, as well as their applications, are summarized. Correspondingly, the challenges in sintering granulation field are proposed to include: (1) Development of iron ore sintering industry; (2) Ore blending optimization based on synergistic coupling of granulation and sintering; (3) Optimization of granulation process and equipment; (4) Methods and tools for granulation scientific research. These issues will be tackled and overcome in the future by both steel enterprises and academic researchers, generating suggestions for future development in the field of sintering granulation.