Offshore Wind Power Systems (OWPS) offer great energy and environmental advantages, but also pose significant Operation and Maintenance (O&M) challenges. In this survey, we analyze these challenges and propose some optimization strategies and technologies for OWPS comprehensively. The existing literature review mainly focuses on a certain field of offshore wind power O&M, but lacks a comprehensive introduction to offshore wind power. We consider the energy efficiency, reliability, safety, and economy of OWPS from various aspects, such as offshore wind and wave energy utilization, offshore wind turbine components, and wind power operation parameters, and compare them with onshore wind power systems. We suggest that OWPS can benefit from advanced design optimization, digital twin, monitoring and forecasting, fault diagnosis, and other technologies to enhance their O&M performance. This paper aims to provide theoretical guidance and practical reference for the technological innovation and sustainable development of OWPS.