Alkaline water electrolysis, as a highly attractive hydrogen production technology, largely depends on the performance of efficient electrocatalysts for cathodic hydrogen evolution reaction. Due to its relatively low price compared with Pt, Ru has similar metal hydrogen bond strength, and its stronger H2O dissociation ability than Pt, so it has quickly become one of the research hotspots in the research of hydrogen production by alkaline water electrolysis. In this review, the basic principle of hydrogen evolution reaction in alkaline media are summarized. Factors affecting the performance of Ru-based catalysts and their regulation strategies are provided. Then a series of commonly used catalyst characterization techniques and methods are introduced. Then, the ruthenium-based catalysts are divided into metallic ruthenium, ruthenium-related compounds and single atom ruthenium. Various Ru-based catalysts have achieved significantly higher alkaline hydrogen evolution activity and stability than Pt/C by adjusting their composition and electronic structure. Finally, the problems and challenges in the basic research and industrial application on the application of Ru-based electrocatalysts in alkaline water electrolysis for hydrogen evolution were discussed.