Concrete pumping is widely utilized in various engineering projects for its high efficiency and cost-effectiveness. However, adverse flow issues such as stratification, segregation and pipe blockage during the pumping process have not been fully resolved. Due to the complex multi-phase and multi-component nature of concrete, its dynamic rheological behavior is difficult to characterize accurately using traditional empirical formulas and experimental methods. Furthermore, the quantitative relationship between rheological parameters and pumpability is hard to establish. To address these limitations, numerical simulation is regarded as an effective alternative. Three categories of numerical simulation methods for concrete pumping behavior—the continuum approach, the discrete element method, and multi-physics coupling were systematically reviewed. Their respective advantages, limitations, and application scopes were compared. It is observed that the continuum approach is characterized by efficient prediction of macro-engineering parameters, while the discrete element method is preferred for parsing micro-scale particle mechanisms. Additionally, fluid-structure interactions and other complex phenomena can be more realistically reproduced through multi-physics coupling. Recent research progress regarding lubrication layer characteristics, pumping pressure loss, pipeline wear, and concrete segregation was summarized and reviewed. Finally, the challenges and future prospects of numerical methods in theoretical model construction, computational efficiency, and application expansion were discussed.