Sandwich structures are important innovative multifunctional structures with the advantages of low density and high performance. Creative design for sandwich structures is a design process based on sandwich core structure evolution mechanisms, material design method, and panel (including core structure and facing sheets) performance prediction model. The review outlines recent research efforts on creative design for sandwich structures with different core constructions such as corrugated core, honeycomb core, foam core, truss core, and folded cores. The topics discussed in this review article include aspects of sandwich core structure design, material design, and mechanical properties, and panel performance and damage. In addition, examples of engineering applications of sandwich structures are discussed. Further research directions and potential applications are summarized.