The convergence of metamaterials and quantum optics heralds a transformative era in photonic technologies, poised to revolutionize applications ranging from information processing and imaging to sensing and beyond. This review explores the synergistic integration of metasurfaces—engineered sub-wavelength planar structures—and quantum optics, which exploits quantum mechanical principles to manipulate light at the most granular level. We outline the design principles, fabrication processes, and computational challenges involved in creating quantum metasurfaces, discussing both forward and inverse design approaches. Advances in nanofabrication and intelligent optimization techniques, such as machine learning and topology optimization, have enabled the development of metasurfaces with unparalleled control over electromagnetic waves. We examine recent progress in using quantum metasurfaces for single-photon and multi-photon generation, quantum imaging, and quantum sensing, showcasing how these innovations achieve unprecedented precision and novel functionalities. Additionally, we highlight the integration of metasurfaces into quantum light manipulation, emphasizing their role in enhancing wavefront shaping and entanglement control. By providing a comprehensive survey of current advancements and future research directions, this review highlights the vast potential of metasurfaces and quantum optics at the crossroads, setting the stage for next-generation technological innovations that will define the forthcoming decade.