Emulsions can be easily destabilized under various conditions during preparation and storage. Therefore, it is necessary to understand the factors that influence the stability of emulsions, which is essential for their subsequent studies. Sodium caseinate (CAS) is a well-used nutritional and functional ingredient in emulsion preparation due to its good solubility and emulsifying properties. CAS-stabilized emulsions can be considered good food emulsion delivery systems, but their applications are still limited under certain conditions due to their instability to creaming and aggregation. Therefore, the purpose of this review is to provide a complete overview of how different environmental stresses and processing conditions affect the stability of CAS-stabilized emulsions and how to improve their stability. Initially, the general properties of CAS as emulsifiers and the characterization of CAS-stabilized oil-in-water (O/W) emulsions were summarized. Second, the major instability mechanisms that operate in CAS-stabilized emulsions were presented. Furthermore, the general factors such as pH, emulsifier concentration, ionic strength, oxidation, and processing conditions, affecting the stability of CAS-stabilized O/W emulsion, were discussed. On this basis, the commonly used methods for evaluating emulsion stability are introduced. Finally, state-of-the-art strategies to improve CAS-based emulsion stability are also described and summarized. This review is expected to provide a theoretical basis for the future applications of CAS in food emulsions.