Vinegar is widely recognized for its distinctive flavor, nutritional value, and numerous health benefits, which are particularly attributed to the presence of tetramethylpyrazine (TMP). TMP not only contributes to the aroma of vinegar but also exhibits significant anti-inflammatory, antioxidant, and cardioprotective effects. Despite the substantial body of research on this compound, the available information regarding TMP in vinegar remains fragmented, highlighting the need for a comprehensive review. This article conducts a bibliometric analysis of publications on TMP in vinegar indexed in the Scopus database between 2010 and September 2024. The review explores the production mechanisms, modes of action, and detection methods of TMP in vinegar, in relation to the vinegar fermentation process. It provides an in-depth analysis of the key stages in TMP production, including fermentation conditions, strain selection, and post-fermentation treatments, as well as optimization strategies. Additionally, it examines the main genes involved in TMP biosynthesis and their associated regulatory networks. The review integrates recent advances in this field and outlines future research directions, with the ultimate goal of offering theoretical insights and technical guidance for the advancement of vinegar production and the development of related functional foods.