Abstract: Coal gangue is a solid waste generated in the process of coal production, which is one of the largest industrial solid wastes in China, and contains a variety of valuable elements and has potential utilization value. Due to coal gangue contains complex mineral components and a variety of valuable elements, which exhibits chemically stable, and it is necessary to carry out activation pretreatment to improve the reactivity of mineral components in coal gangue to realize the high-value utilization. At present, the commonly used coal gangue activation pretreatment methods mainly include mechanical activation, thermal activation, chemical activation, microwave activation, and compound activation. Based on the phase transformation and microstructure reconstruction behavior of minerals under different activation pretreatments, the mechanism of different activation pretreatment methods and the phase transformation process of minerals were summarized and analyzed. In addition, the differences in composition and utilization of different types of coal gangue, as well as the chemical structure and physicochemical properties of the two most important mineral components in coal gangue were introduced. Finally, the existing research problems in different activation pretreatment methods were discussed, and the future research development directions and possible solutions were proposed. Through the summary and induction, it will provide a theoretical reference for the activation pretreatment and high-value comprehensive utilization of coal gangue in the future.