The aviation industry is a key market that promote additive manufacturing (AM) technology since there are huge demands for precision manufacture of high-value complex structural parts and repair of local defects. Extensive research has been conducted on AM process, characterization, and fatigue evaluation of titanium alloy, but there are rare comprehensive reviews on fatigue evaluation methods used for AM aero-engine blades. Rigorous tests, evaluation, and certification are necessary before AM technology is applied in aero-engine blade repair, although it has shown great advantages in different engineering fields. This paper introduces the application of AM technology in the manufacturing and repair of aero-engine titanium alloy blades, summarizes the key factors affecting the fatigue performance of AM titanium alloys, thoroughly discusses the fatigue mechanism, research methods, and process optimizations of AM parts, and compares the differences among several prediction models in fatigue evaluation of AM titanium alloys.