This work intends to provide a comprehensive review on the development of Al2O3-C refractories with low/ultra-low carbon content. It covers three parts: carbon materials, microstructure optimization of the refractory matrix by ceramic phases, and application of metal Al as raw material. Carbon black, expanded graphite, and ultrafine microcrystalline graphite, as price competitive carbon materials, can be chosen to prepare the low-carbon Al2O3-C refractories after some special treatment. Ni/Co/Fe-catalyzed phenolic resin contributes to improving the properties of the low-carbon Al2O3-C refractories. The performance deterioration of the low-carbon Al2O3-C refractories can also be improved by in-situ formed or pre-synthesized ceramic phases. Metal Al, characterized by plasticity forming, acceleration of sintering, oxidation resistance, and high reactivity, can be used as raw materials to completely replace graphite, and the prepared resin bonded Al-Al2O3 based refractories are one novel development direction of the ultra-low carbon Al2O3-C refractories.