Tandem mass spectrometry (MS/MS) is crucial for small-molecule analysis; however, traditional computational methods are limited by incomplete reference libraries and complex data processing. Machine learning (ML) is transforming small-molecule mass spectrometry in three key directions: ( a ) predicting MS/MS spectra and related physicochemical properties to expand reference libraries, ( b ) improving spectral matching through automated pattern extraction, and ( c ) predicting molecular structures of compounds directly from their MS/MS spectra. We review ML approaches for molecular representations [descriptors, simplified molecular-input line-entry (SMILE) strings, and graphs] and MS/MS spectra representations (using binned vectors and peak lists) along with recent advances in spectra prediction, retention time, collision cross sections, and spectral matching. Finally, we discuss ML-integrated workflows for chemical formula identification. By addressing the limitations of current methods for compound identification, these ML approaches can greatly enhance the understanding of biological processes and the development of diagnostic and therapeutic tools.