Geopolymer is a novel type of inorganic cementitious material prepared from aluminosilicate industrial solid waste and burnt clay as raw materials through a process of “depolymerization-condensation-reconstruction” under the action of chemical excitation. Compared to traditional Portland cement, geopolymer is known as the most promising green cementitious material in the 21st century due to its low-carbon environmental protection, controllable structure, and adjustable performance during the preparation process. At the same time, geopolymer has the material and structural genetic characteristics of zeolite minerals due to the formation process similar to synthetic zeolite. Based on the ion exchange and adsorption properties of zeolite, the application of geopolymers as an adsorption material for sewage treatment is rapidly becoming a research hotspot. This paper summarizes the synthesis mechanisms and structural characteristics of geopolymers, outlines the current research status of geopolymers in the field of sewage treatment, and discusses the problems and development prospects of geopolymers in the field of sewage treatment.