In view of the research status and main problems of artificial island construction in the underwater tunnel engineering, this study collects typical engineering cases of artificial island in the underwater tunnel projects, and summarizes key construction technologies of foundation treatment, cofferdam construction and fill reinforcement of artificial islands. Two main problems in the construction process of underwater tunnel artificial islands were proposed: firstly, the combination of schemes and process optimization for the soft foundation treatment and the soil filling reinforcement; secondly, the utilization rate of dredged soil in the construction of artificial islands in China was relatively low. Based on the existing construction technology of artificial islands, the future development direction of artificial island construction is to achieve the green and rapid island building through prefabricated artificial island components.