Metal additive manufacturing (MAM) technology can realize the large-and-complex parts of the titanium alloy with high performance solid free forming, is widely used in aviation, aerospace, power and energy industry in recent years. Based on the relationship between microstructure and mechanical properties, this review describes the as-deposited, heat-treated microstructure and texture in AM Ti-6Al-4V alloy, and tensile and fatigue properties. In addition, we point out the key issues in MAM Ti-6Al-4V alloy and the developing trends in AM Ti-6Al-4V alloy.