Vascular anastomosis, as one of the core surgical techniques, directly determines clinical efficacy in trauma repair, organ transplantation, and vascular reconstruction. This paper systematically reviews the development and current research status of vascular anastomosis techniques such as traditional manual sutures, robotic-assisted technologies, biomedical adhesives, and energy welding. Traditional manual sutures, regarded as the gold standard of vascular anastomosis, have achieved ultra-precise anastomosis at the 0.1-mm level through advancements in microsurgical techniques, making them the most clinically prevalent method. However, they are limited by issues such as foreign body retention, high demands on surgeon, prolonged operative times, and high postoperative stenosis rates. Robotic-assisted systems offer enhanced precision in complex anatomical regions, achieving submillimeter accuracy. However, their widespread adoption is constrained by high costs, reliance on suturing, and steep learning curves. Biomedical adhesives and energy welding techniques significantly reduce operative time but are not yet clinically applicable due to insufficient anastomotic strength. Although the GEM Coupler stapling devices have been clinically applied, other stapling technologies remain limited in scope, with ongoing research in structural designs and biodegradable materials. Future advances in vascular anastomosis are expected to focus on three directions: material innovation, technological breakthroughs, and clinical translation.