Abstract: Climate change and rapid urbanization pose severe risks to urban drainage systems (UDSs). In particular, the mismatch between urban drainage infrastructure and urban development needs is increasingly likely to cause UDS overflows. Real-time control (RTC) has the potential to significantly improve the operational efficiency of UDSs, providing an effective means of alleviating these overflows. However, the uncertainties associated with the complex hydraulic characteristics and harsh operating environment of UDSs mean that RTC may be ineffective or provide only insignificant benefits. This paper reviews the causes and analyzes the influence of these uncertainties from the perspectives of data, RTC methods, process models, and drainage conditions. Research progress on the RTC of UDSs is summarized in terms of uncertainty characterization and RTC modeling, which combines uncertain variables with efficient and robust solutions. Potential research directions are proposed as a means of addressing the limitations of previous studies, including the impact of data observation errors on RTC, risk control strategies for responding to emergencies, multiobjective control models that couple multidimensional uncertainties, and improving the timeliness of RTC models.