Natural gas hydrate (NGH) is regarded worldwide as the most promising clean energy. Research on the exploration and exploitation of NGH has come to a stage of breakthrough in China. However, the accumulation mechanism and occurrence regularity of NGH from muddy silt in the South China Sea remain unclear, and the hydrate decomposition and phase transformation mechanisms during exploitation as well as safe and efficient technologies require further study. This study reviewed the research and application status of NGH exploitation technologies including depressurization and solid fluidization. Moreover, corresponding suggestions were proposed considering the existing problems regarding current NGH exploitation technologies. Specifically, basic research and major engineering should be promoted for multi-gas exploitation of NGH and deep oil and gas; technology innovation and integration should be strengthened to promote synergy between theory and practice; a numerical simulation big science platform should be established for pilot scale tests and multi-field coupling; and relevant standards need to be established and improved. This can improve the research level and technical maturity of NGH exploitation in China, facilitate its large-scale commercial development, and ensure energy security of China.