With the upgrading of public demands for oral aesthetics, the limitations of traditional oral aesthetic restoration, which mainly relies on doctors’ subjective experience evaluation and lacks standardized quantitative aesthetic criteria, have become increasingly prominent. As a digital diagnosis and treatment method integrating computer digital technology, oral clinical practice and modern aesthetics, Digital Smile Design has become an important technique for optimizing oral aesthetic restoration. Relying on high-definition facial image acquisition and three-dimensional scanning modeling, this technology realizes quantitative measurement of aesthetic indicators including patients’ facial soft tissues, lips and dentition. It presents restoration effects in advance based on visual simulation and formulates personalized restoration schemes meeting patients’ requirements. This paper systematically sorts out commonly used clinical acquisition equipment, core design software such as Keynote and standardized digital design procedures of this technology, summarizes its clinical pathways in multiple oral aesthetic restoration scenarios including anterior porcelain veneers, anterior full crowns and edentulous implant dentures, and concludes its application advantages, so as to provide theoretical reference for the selection of clinical schemes.