As a crucial branch for titanium industry, high-strength titanium alloys (HS-TAs, with UTS ≥ 1100 MPa) are indispensable structural materials for advanced engineering applications such as aerospace and marine fields. Along with the expansion of HS-TAs’ market, achieving satisfying synergies of high strength, high ductility (elongation ≥ 6%) and high toughness (KIC≥ 50 MPa⋅m1/2) has been identified as the uppermost technical bottleneck for their research and development. To overcome the challenge, two primary strategies have been initiated by the titanium community, developing novel alloys and innovating processing technologies. For the former, a dozen of newly-developed alloys were reported to exhibit excellent strength-ductility-toughness combinations, including Ti-5553, BT22, TC21 and Ti-1300, for which the ideal mechanical performances were based on specific microstructures realized by low impurity rate (e.g. oxygen content ≤ 0.15 wt%), complicated processing and complex heat treatment. For the latter, several innovatory forging and heat treatment technologies were originated for the mature alloys to optimize their balanced property by extraordinary microstructural characteristics. In this review, we provide a comprehensive overview over the research status, processing and heat treatment technologies, phase transformation, processing-microstructure-property correlation and strengthening-toughening mechanism of HS-TAs for aerospace engineering applications manufactured via melting-forging process. Finally, the prospects and recommendations for further investigation and development are proposed based on this review.