Complex geological conditions and unreasonable tunneling parameters cause abnormalities or damage to tunnel boring machine(TBM) cutters, increasing cutter consumption and affecting tunneling efficiency. The common failure modes of TBM cutters are discussed. In addition, the influence of driving parameters, such as total thrust, cutterhead rotation speed, and cutter penetration, as well as the geological parameters, such as the uniaxial compressive strength and the quartz content of different surrounding rocks, on cutter wear and abnormal damage are investigated. Furthermore, case studies on the Qinling tunnel of Hanjiang riverWeihe river water conveyance and Zhongtianshan tunnel projects are conducted, statistically analyzing the consumption and the failure forms of the cutters. Thereafter, optimization methods based on cutter selection, inspection, and maintenance are proposed. Finally, the current situation under which some problems exist in the cutter configuration and monitoring technology is introduced. It is concluded that cutter configuration technology with adjustable cutter spacing should be further developed to ensure the rockbreaking efficiency of cutters under various geological conditions. In addition, there is a need for new cutter condition monitoring systems with strong adaptability to the TBM working environment.