Dongting Lake is an important storage lake in the middle reaches of the Yangtze River, and its complex groundwater system and prominent groundwater environmental problems have received continuous attention. This paper first summarizes and discusses the research results from three aspects: the Quaternary tectonic evolution, structure and circulation characteristics of groundwater system, and groundwater environment and associated influencing factors of the Dongting Lake Basin. Then, the research prospects of the groundwater system and environment of Dongting Lake were presented. The strong Quaternary tectonic activity in the Dongting Lake Basin has accumulated and deposited Quaternary sediments with an average thickness of 150 m, shaping the tectonic and stratigraphic pattern for the groundwater system in the lake area. The groundwater system in the Dongting Lake area is controlled by multiple factors such as the overall topography of the basin, basement tectonic pattern, aquifer distribution, and surface river and lake systems, and the water circulation process is very complex. Influenced by the primary geochemical environment and human activities, groundwater in a large area of the Dongting Lake Plain has problems of water quality factors exceeding the standards, such as iron, manganese, ammonia, and nitrogen, and many water quality factors show obvious spatial distribution patterns. Based on the existing research results and the needs of the Dongting Lake Plain in terms of water resources allocation, wetland protection, and ecological environment management. This paper argues that future research on the groundwater system and environment of Dongting Lake will be focused on 1) the water exchange process and its biogeochemical succession law in the vertical interaction zone of Dongting Lake plain area, 2) the scale differentiation and surface water-groundwater interaction of the Dongting Lake groundwater system under the complex river-lake system, and 3) the water environment evolution mechanism of the lake plain under the coupling effect of multiple elements in the Dongting Lake Plain.