<p>Porthole die extrusion is a pivotal process method for manufacturing hollow thin-walled profiles, and its forming process is also a complex thermodynamic coupling process with numerous influencing factors. The design of porthole die is one of the key technologies for hollow profile extrusion. The traditional design approach for porthole extrusion dies relies heavily on the designers’ experience and knowledge, characterized by long development cycles and high testing costs. The advancements of finite element simulations, optimization methods, and machine learning techniques have provided many new tools and strategies for the design and optimization of porthole dies. In this paper, the structural forms of porthole dies were classified based on the characteristics and dimensions of hollow profiles, and a comprehensive discussion and comparison was presented. The evaluation system of extrusion forming quality was summarized, and corresponding evaluation criteria were compared. Various design and optimization methods of porthole dies were systematically analyzed, and their respective advantages and disadvantages were compared. The influence and mechanism of die structural and process parameters related to extrusion forming quality were summarized, and the principles for selecting parameters were identified. The future development direction of porthole die design for hollow thin-walled profiles was discussed, and the importance of technological innovation was emphasized.</p>