Currently, operations of reversible pump turbines in pumped hydro energy storage plant suffer great instability problems in the well-known S-shaped characteristic regions, leading to the failure of start, significant pressure fluctuations, and severe vibrations of the whole system. One of the physical origins of the above instability of reversible pump turbines is the rotating stall phenomenon generated at off-design conditions in generating mode. In this review, recent studies on the rotating stall of reversible pump turbines are critically reviewed with a focus on the generating mode. In reversible pump turbine, the rotating stall initiates at runaway and is fully developed at low discharge condition with characteristic rotating frequency being 50–70% of the impeller rotational frequency. Notorious effects induced by rotating stall include generation of large pressure fluctuation, channel blockage, and strong backflow, all of which contribute significantly to the instability of reversible pump turbine. Methods for identification of rotating stall are also introduced with plenty of examples. Finally, several suggestions on the future work are given and discussed.