Marine spatial planning (MSP) was developed as a process for managing the marine environment under the scenario of increased demand for space with different uses and economic activities. In the last decades, the research interest in MSP has been reflected by the growing number of published scientific articles on this subject. Nonetheless, a systematic scientific literature review on MSP is still lacking. In this context, the present study is aimed at performing a global review highlighting the main trends and patterns of scientific article contents focusing on the concepts, approaches, and tools that have been used to inform and shape MSP. After text screening and application of the eligibility criteria, a total of 476 articles published between 2004 and 2020 were included in the analysis. The results showed that most studies published so far (74%) focused on conceptual aspects of governance issues (n = 98), investigated the role of economic activities in MSP (n = 98), evidenced the solutions that have been adopted to implement national plans (n = 71), or explored the strategies used to involve stakeholders in MSP (n = 83). A trend towards MSP applicability was expressed by the increasing number of studies related to stakeholders’ engagement methodologies, together with the development of decision support tools for MSP implementation in recent years. Overall, including progressive methodologies in the evaluation and assessment of all stages of MSP are needed to foster its applicability.