Sugarcane (Saccharum officinarum L.), a globally cultivated carbohydrate-producing crop, has considerable industrial significance. Its optimal growth and yield require soils rich in water and nutrients. However, due to its glycophytic nature, sugarcane production is being severely limited by increasing soil salinity. Salinity is a major abiotic stress factor worldwide, presenting complex challenges to soil fertility, vegetative growth of crops, agricultural production, and food security. The cultivation of sugarcane under salinity induces ionic toxicity and osmotic stress, leading to severe alterations in physiological, biochemical, molecular, and metabolic processes that regulate the growth, development, adaptation, and survival of crop plants under adverse conditions. The extent of damage, however, may vary according to the tolerance level of crop genotypes and the cropping environment. Increasing sugarcane production under adverse conditions is essential to meet growing demand; however, relatively little effort has been directed toward exploring salinity tolerance and genetic variation in sugarcane compared with other crops. This review aims to examine the adverse effects of salinity on sugarcane, explore the basis of salinity tolerance, and provide an overview of recent advances in salinity tolerance research in sugarcane. Understanding the mechanisms of salinity tolerance and identifying salinity-tolerant genotypes are critical for enhancing sugarcane production on salt-affected lands, which will be essential to meet future demand.