Abstract: Electrocatalytic ozonation (ECO) has emerged as a prominent research hotspot in water treatment, owing to its rapid reaction kinetics, high efficiency in organic mineralization, and relatively low operational costs. This review systematically summarizes recent advances in ECO technology, focusing on the following aspects: (1) classification of operational modes, including electrocatalysis followed by ozonation, ozonation followed by electrocatalysis, and integrated electrocatalysis-ozone systems; (2) key influencing factors, with an emphasis on anode materials (e.g., nickel-antimony co-doped tin oxide, graphite felt, and activated carbon fiber), cathode materials (e.g., carbon-polytetrafluoroethylene composites and iron-nitrogen co-doped carbon nanotubes), and operational parameters such as current density, ozone concentration, and solution pH; and (3) application scenarios, highlighting performance evaluations in complex aqueous matrices including antibiotic wastewater, dyeing wastewater, and landfill leachate. Regarding mechanisms, this review analyzes the generation and roles of reactive oxygen species (ROS) in ECO systems, particularly the formation pathways of hydroxyl radicals (·OH), synergistic effects, and their contributions to pollutant degradation. Using typical contaminants such as phenol and ibuprofen as model compounds, it analyzes the oxidation intermediates, bond cleavage patterns, and final mineralization in detail. Additionally, the formation of chlorate and other by-products during the treatment of chloride-containing wastewater is addressed. Despite its potential, ECO technology faces challenges in practical implementation, including the long-term stability and versatility of electrode materials under complex water conditions, as well as the intricate interactions of multiple ROS that complicate reaction pathways. Finally, this review outlines future research directions, such as the development of advanced electrode materials, artificial intelligence (AI)-assisted process optimization, integration with other technologies, and a comprehensive life cycle assessments (LCA) covering environmental and economic aspects. By consolidating recent research and mechanistic insights, this review aims to provide technical support for the large-scale application of ECO technology in water treatment engineering.