Microwave thermoacoustic imaging (MTAI) is an exciting imaging technique rooted from the underlying principle of exploiting the distinct electrical properties of biological tissues. By using short-pulsed microwaves as a stimulation source and their interaction with the human body, MTAI has paved the way for revolutionary advancements in medical imaging. When microwaves are absorbed by polar molecules and ions within the tissues, an ingenious thermoelastic effect gives rise to ultrasound waves. These ultrasound waves, brimming with invaluable pathological and physiological insights, propagate outward, carrying the essence of the composition and functionality of biological tissue. Through a meticulous collection of ultrasound signals from all directions surrounding the tissue, it becomes possible to reconstruct intricate internal structures and visualize the tissue's functional dynamics. The MTAI excels in non-invasiveness, capable of delving several centimeters beneath the surface with a microscopic resolution on the order of micrometers. The magic lies in converting microwave energy into ultrasound waves, entering into the hidden depths of tissues without causing harm. This groundbreaking imaging modality unlocks a realm of possibilities for acquiring profound insights into the intricate structures and functionality of deep-seated tissues. Furthermore, the inherent polarization characteristics of microwaves empower MTAI to capture additional dimensions of information, unraveling the intricate polarization properties and illuminating a richer understanding of the tissue's complexity. The great potential of MTAI extends far and wide within the medicine field. It has made remarkable achievements in non-invasive imaging of brain structures, screening breast tumors, visualizing human arthritis, and detecting liver fat content. These accomplishments have laid a solid foundation, firmly establishing MTAI as a trailblazing medical imaging technique. The present study offers a comprehensive and in-depth exploration of the physical principles underpinning MTAI, the sophisticated system devices involved, and the recent groundbreaking research breakthroughs. Moreover, it delves into the exciting prospects and challenges that lie ahead in the future development of MTAI. As the technology continues to progress by leaps and bounds, MTAI is ready to break down barriers, and usher in a new era of unmatched imaging quality and performance. This, in turn, will open the floodgates for transformative innovations and applications in medical diagnosis and treatment. The anticipation is palpable as MTAI strives to make substantial contributions to the ever-developing medical imaging field, bestowing upon humanity more accurate, reliable, and life-enhancing diagnostic capabilities.