Rice milling is a key stage in rice processing that determines both the quality of milled rice and the efficiency of resource utilization. Its degree of milling directly affects the appearance, eating quality, texture, nutritional composition, and economic indicators such as head rice yield and broken rice rate. For a long time, industrial practice has been largely guided by an empirical preference for a “whiter” appearance, resulting in a processing mode that emphasizes visual quality. However, excessive milling often leads to nutrient loss, increased broken rice rate, and higher energy consumption, thereby reducing the sustainability of rice processing. With the growing emphasis on healthy diets, the demand for moderately milled rice, brown rice, and partially bran-retained rice products has continued to increase. Consequently, how to achieve a quantitative balance among sensory quality, nutritional retention, and processing efficiency has become an urgent issue in the rice-processing field. In view of this, this review focuses on how reproducible moderate milling can be achieved through equipment and process control. It systematically summarizes the evolution of rice milling technologies and equipment, elucidates the relationships among milling mechanisms, broken rice formation, and quality changes, and reviews the effects of milling degree on eating quality, nutritional value, and storage stability. In addition, the review compares the major consensuses and discrepancies in current studies, identifies existing gaps in standardized evaluation indices and in research linking mechanisms, processing conditions, and quality/health outcomes, and discusses future directions for intelligent sensing, digital process control, and health-oriented rice products. This review is expected to provide theoretical support and technical references for moderate rice processing and whole-chain quality and efficiency improvement.