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There is a growing interest in structured light, especially orbital angular momentum (OAM) beams, due to its unique amplitude and phase structure. Multiple orthogonal OAM beams can be utilized to enable high-capacity communication systems in various scenarios. This review will discuss the properties, challenges, advances, and perspectives of OAM-based optical communications, including the following (a) basic multiplexing and encoding links; (b) OAM-based communication in free space and fiber; (c) technical hurdles; (d) mitigation approaches; (e) encoded quantum communications; (f) advanced topics including different frequency ranges and novel beams; and (g) ecosystem and commercialization.