Proton exchange membrane water electrolysis (PEMWE) is regarded as a practical hydrogen production method due to its advantages such as smaller resistance loss, higher current density, and higher hydrogen purity. However, the efficiency of PEMWE technology is severely hindered by the slow kinetics and the high reaction barrier of the oxygen evolution reaction (OER). Therefore, developing cost-effective, efficient, and stable OER electrocatalysts is urgently needed. The RuO2-based electrocatalysts have been proven to be promising alternatives to Ir-based catalysts due to their excellent electrocatalytic activity and high adaptability in acidic environments. This review comprehensively summarizes and discusses the morphological control strategies, advanced modification strategies, and structural synergy of RuO2 catalysts. Furthermore, the composition and industrial development status of PEMWE are elaborated, along with the current research progress of RuO2 as an anode in electrolysis. Finally, relevant suggestions for RuO2 research and practical applications are presented, the challenges facing practical deployment are analyzed, and future research directions are outlined.