High-strength low-alloy (HSLA) steels have garnered significant attention owing to their widespread applications across various industries, with weldability being a particularly critical aspect. However, the impact toughness of the coarse-grained heat-affected zone (CGHAZ) remains a notable challenge under high-heat-input welding conditions. Despite existing research acknowledging the beneficial effects of micro-alloying elements on steel properties, there are still numerous uncertainties and controversies regarding the specific influence of these elements on the microstructure and impact toughness of the CGHAZ under specific welding conditions. To address this issue, this study presents a comprehensive review of the impact of common micro-alloying elements on the microstructure and toughness of the CGHAZ during high-heat-input welding. The results indicate that elements such as cerium, magnesium, titanium, vanadium, nitrogen, and boron significantly improve the toughness of the CGHAZ by promoting intragranular nucleation of acicular ferrite and inhibiting the coarsening of austenite grains. In contrast, the addition of elements such as aluminum and niobium adversely affect the toughness of the CGHAZ. These findings offer crucial theoretical guidance and experimental evidence for further optimizing the welding performance of HSLA steels and enhancing the impact toughness of the CGHAZ.