Complex section products have significant lightweight and functional characteristics, and the twin-roll casting (TRC) is characterized by high efficiency and short flow. Hence, the TRC process for fabricating complex section products combines both advantages and will have a broader market demand and application prospect. In this paper, the research progress in recent years is reviewed, and novel TRC processes are divided into three categories according to the product section characteristics, namely transverse variable profiled strip, longitudinal variable profiled strip, and circular section products. The essence of the TRC process of complex section products is to change the steady-state characteristics in time series and the uniform characteristics in spatial distribution into transient or nonuniform. The technical principle, deformation characteristics, influence mechanism, are systematically analyzed. The current challenges and future directions of the TRC process are discussed.