The twisted oval tube has simple structure, excellent heat transfer enhancement and anti-fouling performance, and has become one of the research hotspots in the field of passive heat transfer enhancement. In recent years, researchers have carried out a lot of research on the heat transfer performance of twisted elliptical tubes (bundles) through experiments and numerical simulations. The mechanism of heat transfer enhancement is explained.Although there are reviews on the technology of twisted oval tube exchangers, there are deficiencies in the induction of the heat transfer enhancement characteristics of twisted oval tubes and the analysis of the research clues of the engineering application. This review focuses on the internal and external heat transfer and flow resistance performance of the twisted oval tube, and summarizes the influence of the structure of the twisted oval tube (bundle), working fluid and flow state on the heat transfer performance and flow resistance characteristics. The review also reviews the engineering application cases of twisted oval tube heat exchangers, and outlines the contents to be perfected in the researches on twisted oval tubes, and prospects the development trend of the research on heat transfer intensification of twisted oval tubes. This review is expected to provide guidance and reference for deepening the theoretical research and engineering practice of twisted oval tubes.