Blast furnace (BF) ironmaking is a complex multiphase process involving gas–solid flow, heat transfer, chemical reactions, burden movement, and phase transformation under high-temperature conditions. Since many internal states of the blast furnace cannot be directly observed during operation, numerical simulation and mathematical modeling have become important tools for understanding furnace behavior and optimizing operational parameters. This paper reviews recent advances in blast furnace numerical simulation and internal state reconstruction methods. Existing approaches, including packed-bed flow models, cohesive zone reconstruction methods, burden distribution models, and temperature field prediction methods, are summarized and discussed. In addition, the evolution of blast furnace mathematical models from early one-dimensional steady-state formulations to modern three-dimensional multifluid and hybrid simulation approaches is reviewed. Recent developments in computational fluid dynamics (CFD), the discrete element method (DEM), digital twin, and data-driven modeling are also discussed. Compared with traditional simplified models, modern multidimensional and hybrid approaches show improved capability in describing asymmetric furnace inner states, multiphase transport behavior, and operational parameter effects under industrial conditions. However, challenges still remain in achieving computational efficiency, parameter calibration, multiphase coupling, and real-time industrial application. Future studies are expected to focus on the integration of mechanism-based simulation and intelligent data-driven methods to improve prediction accuracy, operational adaptability, and intelligent control capability in blast furnace ironmaking.