<p>Casting aluminum alloys with ultrasonic vibration assistance, known as ultrasonic-assisted casting (UAC), has emerged as a prominent topic in recent publications. The advantages of ultrasonic treatment when integrated with conventional casting (CC) techniques, such as direct-chill casting (DC casting), permanent mold casting, or sand casting, have been shown to effectively improve the mechanical properties and microstructural characteristics of cast ingots. The aim of this review is to analyze the literature on ultrasonic processing of aluminum alloys in the past 5 years, from 2019 to 2024. This paper reviews the existing literature and provides a detailed analysis of the experimental setup, the ultrasonic sonotrodes, highlighting their benefits, including reducing grain size, refining the phase structure, minimizing residual stresses, enhancing the tensile strength, elongation, and microhardness of casting samples. In this study, various UAC research with different ultrasonication techniques is discussed and specifically compared. The article also discusses cases in which reinforcing particles are used to improve the mechanical properties of castings during ultrasonic treatment. Additionally, the research discusses future trends in the development and application of UAC studies.</p>