This systematic review investigates the application of microbubble technology in aquaculture, emphasizing its effects on water quality, fish health, and sustainable production. As the demand for intensive and environmentally friendly aquaculture systems grows, oxygenation technologies have become critical to improving production efficiency and animal welfare. Following PRISMA guidelines, articles were retrieved from Scopus, Web of Science, and Google Scholar databases using the descriptors “microbubble,” “nanobubble,” and “aquaculture.” After screening for duplicates and evaluating titles, abstracts, and full texts, a final set of relevant articles was selected for in-depth analysis. The findings demonstrate that microbubble and nanobubble systems offer superior oxygen transfer efficiency compared to traditional aeration methods, improving dissolved oxygen levels and promoting fish immunity and stress resistance. Applications in tilapia culture, integrated aquaculture systems, and biofloc environments show enhanced productivity and reduced dependence on antibiotics. Furthermore, microbubble use supports environmental sustainability by improving biodiversity and nutrient cycling. However, barriers such as high initial implementation costs, lack of standardized operational protocols, and limited technical knowledge among producers still hinder widespread adoption. The review highlights the need for economic feasibility studies, producer training, and integration with other sustainable practices to maximize the benefits of this emerging technology. These findings provide valuable insights for researchers, policymakers, and aquaculture practitioners aiming to modernize production systems through sustainable innovation.