Pisha sandstone (PS) is a special interbedded rock in the middle reaches of the Yellow River that experiences severe weathering and is loose and broken. Due to severe multiple erosion events, the Pisha sandstone region is called “the most severe water loss and soil erosion in the world” and “the ecological cancer of the earth”. As a special pozzolanic mineral, PS has the potential to be used as precursors for the synthesis of green and low-carbon geopolymer gel materials and applied in ecological restoration. This paper aims to undertake a phase review of the precursors for geopolymer gel materials. The genesis and distribution, physical and chemical characterization, erosion characteristics, and advances in the ecological restoration of PS are all summarized. Furthermore, current advances in the use of PS for the synthesis of geopolymer gel materials in terms of mechanical properties and durability are discussed. The production of Pisha sandstone geopolymer gels through the binder jetting technique and 3D printing techniques is prospected. Meanwhile, the prospects for the resource application of PS in mine rehabilitation and sustainable ecology are discussed. In the future, multifactor-driven comprehensive measures should be further investigated in order to achieve ecological restoration of the Pisha sandstone region and promote high-quality development of the Yellow River Basin.