Coal gangue, a predominant solid waste generated during coal mining and beneficiation, poses significant environmental challenges due to its massive accumulation, which not only consumes vast land resources but also induces severe soil and water contamination. Drawing upon the mineralogical and chemical characteristics of coal gangue, this study provides a comprehensive review of recent advancements in its resource utilization as a low-carbon cementitious material. Research indicates that coupling low-temperature thermal activation with mechanochemical techniques effectively stimulates the latent pozzolanic reactivity of coal gangue. Consequently, coal gangue-based binders demonstrate a reduction in lifecycle carbon emissions exceeding 80% compared to traditional Ordinary Portland Cement (OPC). These findings offer critical insights for the high-value valorization of coal gangue and serve as a strategic reference for facilitating the green transformation of the building materials industry.