Abstract: China possesses abundant large water bodies resources, with numerous lakes and reservoirs widely distributed across the country. These water bodies play a vital role in environmental regulation, ecological services, water resource security, and watershed economic development. Cage aquaculture in large water bodies is important in freshwater fisheries. The development of large-scale cage aquaculture in China has undergone three distinct phases: "extensive expansion–environmental governance-driven contraction and adjustment–technological upgrading and ecological transformation." From early unregulated development leading to environmental degradation to recent years, where, under the requirements of ecological civilization construction, cage aquaculture has been gradually phased out in certain areas and subjected to standardized management. Currently, the main aquaculture technologies include feed-based, non-feed-based, multi-layer integrated, and waste-collection systems, which achieve eco-friendly practices through precision feeding, utilization of natural bait, multi-trophic polyculture, and waste collection, respectively. The paper systematically reviews the characteristics and applications of these four cage aquaculture technologies, analyzes core challenges such as the conflict between aquaculture capacity and ecological compatibility, low feed conversion efficiency, and insufficient digital management, and proposes sustainable development pathways. The paper further proposes non-feed-based, multi-layer integrated, and waste-collection aquaculture systems as priority directions for future development. The findings provide scientific support for technological optimization and ecological management decision-making in the industry.