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With the increasing demand for heavy oil, core annular flow (CAF) is an economical method to transport heavy oil, and many researchers have explored the energy-saving aspects of the CAF method. This paper presents a review of CAF energy saving and factors affecting CAF energy saving. Among them, the energy saving of CAF mainly concerns the changes in pressure drop and drag reduction efficiency; the factors affecting the energy saving of CAF mainly concern the problem of stability, the issue of restarting the pipeline system, the impact of a nozzle, the impact of fouling on the flow in the pipe, and the problem of oil–water accumulation. The aim of this paper is to provide a reference for the practical application of CAF in heavy oil transportation.