Abstract: Dental caries is one of the most prevalent oral diseases, significantly affecting public oral health. Current preventive measures, such as oral hygiene practices, fluoride application, and pit and fissure sealants, have not substantially reduced the incidence of dental caries in China. Immunological research on caries prevention in China has a history of over forty years, with considerable achievements and experience, and shows promise for advancing biological caries prevention. This paper reviews immunological research on caries prevention in China from multiple perspectives, including active immunity, passive immunity, and the relationship between steady-state medicine and caries vaccines. It also discusses future development prospects, suggesting that novel adjuvants and carriers are essential for breakthroughs in caries vaccine research.