Vagus nerve stimulation (VNS) is a widely used neurostimulation technique for managing neurological diseases such as drug-resistant epilepsy and depression. Moreover, VNS has shown considerable potential for application in immune diseases. Herein, clinical studies on VNS application in immune disease treatments, such as for rheumatoid arthritis and Crohn’s disease, have been systematically reviewed, with a focus on stimulation methods, clinical efficacy, mechanisms of action, and safety. This review highlights the therapeutic effects of VNS in improving the clinical symptoms of patients with immune diseases through neuroimmune interactions and underscores the need for further large-scale, randomized controlled clinical trials to validate its long-term efficacy and safety.