With the increasing adoption of renewable energy sources globally, hydropower contributes significantly to energy generation through various schemes ranging from big to small-scale plants. In small-scale hydropower plants, the preference for reverse-operated pumps (known as pump as turbines or PATs) over small-scale hydroturbines has increased. However, apart from the associated economic advantages, PATs, like any other hydraulic machinery, are not free from common problems such as cavitation. Cavitation is a phenomenon in which air bubbles are formed within the fluid medium due to substantial local pressure drop and their eventual collapse causes material erosion and degrades the overall machine efficiency. Several studies have focused on PAT conventional operating mode, while its reverse mode just begun to gain research interest. Nevertheless, cavitation remains a common problem in PATs at various hydro-sites. Therefore, to analyze PAT cavitation performance and highlight the differences between its two operating modes in terms of their development mechanisms, this article presents a thorough review of PAT cavitation dynamics and influencing parameters, as well as the future research directions. It is found that PAT reverse mode is more prone to cavitation, but more damages would occur in the conventional mode. Nevertheless, modifying the PAT geometric design parameters can considerably improve its cavitation performance. However, this approach has not been sufficiently investigated for PAT reverse operating mode and hence requires further research. Note that the terms “PAT conventional mode,” “PAT pumping mode,” and “pump” are equally used throughout this paper. • Studies on cavitation performance in hydraulic pumps as turbines (PATs) are reviewed. • Both pump and turbine modes are considered in the review. • PATs are found to have gained importance due to their applicability in remote areas. • PAT reverse mode operations require high heads and flows; prone to cavitation. • Geometric design modification is widely used for PAT cavitation performance improvement.