Thorium has emerged as a promising alternative to uranium in nuclear energy systems due to its higher natural abundance, favorable conversion to fissile 233U, and reduced generation of long-lived transuranic waste. This review provides a comprehensive overview of advanced techniques for thorium recovery from primary ores and secondary resources. The main mineralogical carriers—including monazite, thorianite, thorite, and cheralite as well as industrial by-products such as rare-earth processing tailings—are critically examined with respect to their occurrence and processing potential. Physical enrichment methods (gravity, magnetic, and electrostatic separation) and hydrometallurgical approaches (acidic and alkaline leaching) are analyzed in detail, highlighting their efficiencies, limitations, and environmental implications. Particular emphasis is placed on modern separation strategies such as solvent extraction with organophosphorus reagents, diglycolamides, and ionic liquids, as well as extraction chromatography, nanocomposite sorbents, ion-imprinted polymers, and electrosorption on carbon-based electrodes. These techniques demonstrate significant progress in enhancing selectivity, reducing reagent consumption, and enabling recovery from low-grade and secondary feedstocks. Environmental and radiological aspects, including waste minimization, immobilization, and regulatory frameworks, are discussed as integral components of sustainable thorium management. Finally, perspectives on hybrid technologies, digital process optimization, and economic feasibility are outlined, underscoring the need for interdisciplinary approaches that combine chemistry, materials science, and environmental engineering. Collectively, the analysis highlights the transition from conventional practices to integrated, scalable, and environmentally responsible technologies for thorium recovery.