Abstract: As a crucial freshwater aquaculture species in China, tilapia (Oreochromis spp.) is currently farmed under excessive high-density intensification, which has induced deteriorating culture environments, suboptimal feeding efficiency during high-temperature seasons, and frequent disease outbreaks, severely constraining the sustainable development of the sector. Studies demonstrate that probiotics significantly enhance tilapia growth and disease resistance through multifaceted mechanisms, including improved digestive efficiency and activating immune responses. This review synthesises research from 2011-2025, focusing on the screening criteria for functional probiotics, formulation-processing technologies, and practical implementation strategies in Oreochromis farming. It further elucidates the mechanistic insights into probiotic-mediated optimisation metabolic functions and intestinal microbiota modulation in Oreochromis. Future research directions, including strain-function enhancement and the development of multi-species probiotics formulations, are proposed to provide theoretical foundations for eco-friendly tilapia farming and the green transformation of the sector.