Abstract: Tailings storage facilities are typical degraded ecosystems, and the primary objective of their restoration is to reconstruct stable and self-sustaining ecosystems. The current research and application of three major categories of remediation technologies are summarized: physical and engineering measures, chemical stabilization and amendment, and biological remediation involving plants, microorganisms, and their combined use. Particular attention is given to recent advances in microbial-induced carbonate precipitation (MICP), biochar modification, and sulfur-oxidizing bacteria (SOB)-mediated remediation. The applicability of different remediation strategies to various types of tailings was also evaluated. The results indicate that copper and other sulfide tailings should preferentially be treated using a combination of drainage interception and seepage control, lime-based or carbon-based stabilization, and tolerant plants associated with arbuscular mycorrhizal fungi (AMF). Lead−zinc tailings are more suitable for phosphorus-based, iron-based, or manganese-based stabilization, biochar amendment, and the combined application of plant growth-promoting rhizobacteria (PGPR) and AMF. The remediation of iron tailings should focus on the integrated use of organic matter, modified biochar, pioneer plants, and plant growth-promoting microorganisms. Alkaline bauxite, molybdenum, and some iron tailings may be mildly acidified and subjected to enhanced mineral weathering through the synergistic action of SOB and organic matter. In alpine mining areas, priority should be given to engineering measures for water retention and thermal insulation, native cold-tolerant plants, and cold-adapted functional microbial inoculants. Current remediation practices have evolved from simple soil covering to integrated systems involving multiple complementary technologies. Future tailings restoration should therefore follow a coordinated pathway of “engineering risk control—material amendment—plant establishment—microbial regulation—long-term monitoring”, while improving hierarchical management and remediation-effectiveness evaluation systems. Such efforts will promote the transition from single-method treatment to integrated remediation and facilitate the reconstruction of structurally stable, functionally complete, and self-sustaining ecosystems.