Sludge disposal is an integral part of wastewater treatment systems, and its cost usually accounts for more than half of the total operation cost. Sludge disposal technology is facing challenges and opportunities simultaneously and can still be improved. Sludge dewatering is an essential process in sludge disposal, and it is important for the effective reduction of the final processing cost. Coagulation/flocculation is a relatively mature, cost-effective, user-friendly sludge dewatering technology. In this work, coagulation/flocculation and their combinations with other pretreatments, including dewatering mechanisms, are reviewed. Various coagulants/flocculants used in sludge dewatering, including inorganic coagulants, organic synthetic and natural polymeric flocculants, and bioflocculants, are introduced in detail because coagulants/flocculants are the key in coagulation/flocculation. The different factors that influence the dewatering performance of these coagulants/flocculants are also presented briefly. Moreover, aiming at the complicated composition of sludge and its treatment difficulty, the prospects and technical developments of coagulation/flocculation in sludge dewatering are discussed. Display omitted •Characteristics of different components in sludge and their detection methods.•External and internal factors of coagulation/flocculation on sludge dewatering.•Comparison and assessment of different coagulants/flocculants in sludge dewatering.•Combination of coagulation/flocculation with other techniques and their mechanisms.•Prospects and technical developments of coagulation/flocculation in sludge dewatering.