Abstract: Monopterus albus is the first vertebrate species to be identified as exhibiting the natural phenomenon of hermaphroditism and sex reversal. The transition from ovary to spermatheca in Monopterus albus is characterised by significant changes in cell types and gene expression. Elucidation of these mechanisms is of considerable value in our understanding of reproductive development in fish. Monopterus albus is a commercially significant aquaculture species in China. The difficulty of artificial fry breeding and the lack of high-quality varieties represent the bottlenecks limiting Monopterus albus farming development. This review presents the current status of basic research on the sex reversal process and regulation mechanism of Monopterus albus, as well as recent advancements in breeding technique, the creation of excellent germplasm, and the cultivation of diverse varieties. The objective is to provide valuable insights into the regulatory mechanism of sex reversal in Monopterus albus, a classic yet challenging scientific issue, with the aim of promoting the high-quality development of the aquaculture industry.