Aerodynamic optimization in vehicle body design has become a critical focus in the automotive industry, driven by the growing demands for energy efficiency, extended electric vehicle range, and enhanced driving stability. This review systematically summarizes the state-of-the-art research on aerodynamic considerations and optimization strategies for vehicle bodies, structured around three core themes. First, it elaborates on the fundamental aerodynamic principles underlying body design, including key forces (drag, lift, side force), flow field characteristics (boundary layer separation, vortex generation), and critical design parameters (overall body shape, detailed components, aerodynamic add-ons) that govern aerodynamic performance. Second, it discusses the construction of aerodynamic models and problem-solving approaches, covering numerical simulation (CFD) with common software and turbulence models, experimental testing (wind tunnel and road tests), and optimization frameworks integrating parametric modeling, sensitivity analysis, and advanced algorithms (e.g., genetic algorithms, machine learning). Third, a typical case study of aerodynamic optimization for a passenger vehicle is presented, followed by an analysis of future trends, such as AI-driven automated design, active aerodynamic systems, multi-physics coupling simulation, and the synergistic optimization of aerodynamics with lightweight design and electric vehicle-specific requirements. This review synthesizes the current knowledge of aerodynamic design and optimization for vehicle bodies, identifies key challenges in balancing performance, styling, and manufacturing feasibility, and provides insights for future research and engineering practice in the automotive sector.