Nuclear energy is a low-carbon, safe, efficient, and sustainable clean energy. The new generation of nuclear energy systems operate in harsher environments under higher working temperatures and irradiation doses, while traditional nuclear power materials cannot meet the requirements. The development of high-performance nuclear power materials is a key factor for promoting the development of nuclear energy. Oxide dispersion strengthened (ODS) steel contains a high number density of dispersed nano-oxides and defect sinks and exhibits excellent high temperature creep performance and irradiation swelling resistance. Therefore, ODS steel has been considered as one of the most promising candidate materials for fourth-generation nuclear fission reactor cladding tubes and nuclear fusion reactor blankets. The preparation process significantly influences microstructure of ODS steel. This paper reviews the development and perspective of several preparation processes of ODS steel, including the powder metallurgy process, improved powder metallurgy process, liquid metal forming process, hybrid process, and additive forging. This paper also summarizes and analyzes the relationship between microstructures and the preparation process. After comprehensive consideration, the powder metallurgy process is still the best preparation process for ODS steel. Combining the advantages and disadvantages of the above preparation processes, the trend applied additive forging for extreme manufacturing of large ODS steel components is discussed with the goal of providing a reference for the application and development of ODS steel in nuclear energy.