Abstract: Cemented paste backfill (CPB) has been one of the best practical approaches for tailings management and underground goaf treatment. Paste rheology is a science to study the flow and deformation behaviors of paste or filling body under the effects of stress, strain, temperature, and time during the CPB process. The goal of studying paste rheology is to solve the engineering problems existing in four key processes; that is, paste rheology should meet the engineering demands of thickening, mixing, transportation, and backfilling. However, paste rheology is extremely complicated due to its high concentration, materials complexity, and engineering characteristics of non-stratification, non-segregation, and non-bleeding. The rheological behavior of full tailings in deep thickening, rheological behavior of paste in mixing and pipeline transportation, and rheological behavior of filling body are introduced and discussed: (1) gel point, compressive yield stress, and the hindered settling function are adopted to characterize the rheological properties of full tailings in deep thickening. Combination of Coe–Clevenger theory and Buscall–White theory can also analyze the thickening performance in the whole area of deep cone thickener; (2) yield stress and viscosity are consistent with the evolution trend of the relative structure coefficient of paste in mixing; (3) coupling effect of wall slip and time–temperature dependency has a significant influence on the rheological properties and pipeline transportation; (4) damage variable is introduced to the Burgers model to describe the creep damage of the filling body. However, in-depth and systematic studies were still needed to establish a complete theoretical system of paste rheology in metal mines.