Oncolytic virotherapy (OV) is an emerging and innovative approach to cancer treatment. By inducing virus-mediated immune responses, oncolytic viruses enhance tumor specificity, stimulate antitumor immunity, and selectively infect and lyse cancer cells. In this study, we conducted a systematic review of oncolytic virotherapy, summarizing the major types of oncolytic viruses and their applications in combination therapies. Different viral vectors possess distinct biological characteristics, and diverse strategies have been employed in the design and optimization of OVs. Given their ability to modulate immune responses and the tumor microenvironment, oncolytic viruses show strong potential when combined with conventional cancer treatments. In particular, combinations of OVs with immunotherapies and CAR-T cell therapies are discussed in detail. Nevertheless, the selection of combination strategies should take into account tumor location, standard treatment modalities, and the expression of relevant biomarkers to maximize therapeutic efficacy.