Per- and polyfluoroalkyl substances (PFASs) have emerged as potential health risks in milk and dairy products due to their chemical inertness and bioaccumulative properties. This paper systematically reviews the detection methods, migration and transformation mechanisms, and pollution control strategies for PFASs in milk and dairy products. Sample preparation techniques including liquid-liquid extraction, solid-phase extraction, QuEChERS (quick, easy, cheap, effective, rugged, and safe), supercritical fluid extraction, and metal-organic framework-based dispersive solid-phase extraction have been widely applied in conjunction with liquid chromatography-tandem mass spectrometry and high-resolution mass spectrometry to achieve precise quantification of PFASs at trace to ultra-trace levels. PFASs migrate through the “environment-feed-cattle-milk” pathway, with significant differences in accumulation and transfer efficiency between short-chain and long-chain PFASs. In dairy cows, PFASs primarily distribute in serum protein-bound forms, and some novel PFASs exhibit uncertainties in biotransformation. During dairy processing, thermal treatment and contact materials may cause redistribution or migration of PFASs. Finally, a comprehensive pollution control strategy combining source control, production process interventions, and active removal technologies provides a scientific basis for reducing exposure to PFASs from dairy products. This review aims to offer theoretical references and practical guidance for dairy product safety regulation, risk assessment, and pollution prevention.