Surface roughness refers to the micron- or nanometer-scale irregularities (bumps and grooves) on material surfaces, and it varies greatly as particles are refined, affecting their flotation behavior, wettability, and bubble–particle interactions. In this paper, the main roughening and measurement methods for surface roughness are summarized, the effects of surface roughness on flotation behavior and wettability are reviewed, and the main wettability models for rough surfaces are also introduced. Grinding is the most commonly used method, while other methods, such as acid etching, abrasion, sand-blasting, ultrasonic pretreatments, and microwave treatments, have also been explored. Most research shows that increasing the surface roughness effectively enhances the hydrophobicity of hydrophobic surfaces and the hydrophilicity of hydrophilic surfaces. This improvement leads to better flotation recovery and kinetics for hydrophobic surfaces, whereas it deteriorates that for hydrophilic surfaces. Moreover, the relationship between surface roughness and bubble–particle interactions, including bubble–particle attachment, interaction energy, and interaction force, is introduced. Most research shows that increased surface roughness effectively decreases the attachment time and energy barrier and increases the adhesion force between air bubbles and rough hydrophobic surfaces. Conversely, these effects can be detrimental to rough hydrophilic surfaces. This paper also addresses existing problems and challenges in the field and offers references and suggestions for future research efforts.