In recent years, volatile fatty acid (VFA) production through anaerobic fermentation of sewage sludge, instead of methane production, has been regarded as a high-value and promising roadmap for sludge stabilization and resource recovery. This review first presents the effects of some essential factors that influence VFA production and composition. In the second part, we present an extensive analysis of conventional pretreatment and co-fermentation strategies ultimately addressed to improving VFA production and composition. Also, the effectiveness of these approaches is summarized in terms of sludge degradation, hydrolysis rate, and VFA production and composition. According to published studies, it is concluded that some pretreatments such as alkaline and thermal pretreatment are the most effective ways to enhance VFA production from sewage sludge. The possible reasons for the improvement of VFA production by different methods are also discussed. Finally, this review also highlights several current technical challenges and opportunities in VFA production with spectrum control, and further related research is proposed.