Antibiotic resistance genes (ARGs) in livestock wastewater resulting from excessive antibiotics used in animal farming pose significant environmental and public health risks. Conventional treatment methods are often costly, inefficient, and may inadvertently promote ARG transmission. Microalgae, with their long genetic distance from bacteria and strong ability to utilize wastewater nutrients, offer a sustainable solution for ARG mitigation. This review studied the abundance and characterization of ARGs in livestock wastewater, highlighted microalgal-based removal mechanisms of ARGs, including phagocytosis, competition, and absorption by extracellular polymeric substances (EPS), and explored factors influencing their efficacy. Notably, the microalgae-EPS system reduced ARGs by 0.62–3.00 log, demonstrating significant potential in wastewater treatment. Key challenges, such as optimizing algal species, understanding EPS-ARG interactions, targeted reduction of host bacteria, and scaling technologies, were discussed. This work provides critical insights for advancing microalgal-based strategies for ARG removal, promoting environmentally friendly and efficient wastewater management.