Alginate-based hydrogels, derived from brown seaweed, represent biocompatible and biodegradable materials whose properties are systematically controlled through molecular structure (M/G composition), crosslinking strategy, and compositional modification. This review synthesizes recent advances in alginate hydrogel design, encompassing fundamental structural properties, three primary crosslinking approaches—ionic coordination with divalent cations (Ca²⁺, Ba²⁺, Sr²⁺), covalent chemical linkages, and hybrid multi-crosslinking systems—and strategic modification strategies including chemical derivatization, polymer blending, and nanoparticle incorporation. These modifications address inherent limitations of native alginate, namely insufficient mechanical strength and biological inertness, thereby expanding applicability. The review examines applications across biomedical domains (drug delivery, tissue engineering, wound healing), environmental remediation, food industry systems, and emerging technologies including flexible electronics and soft robotics. Advanced fabrication techniques—3D/4D printing, microfluidics, and electrospinning—enable improved architectural control. Current evidence from preclinical and clinical studies demonstrates feasibility in specific applications, while important challenges persist, including predictable degradation kinetics, mechanical property optimization, standardization of characterization protocols, regulatory compliance, and manufacturing scalability. This review aims to provide a systematic assessment of alginate-based hydrogel development and identify areas requiring further investigation to advance clinical translation.