In this paper, we review high-capacity underwater optical communications using orbital angular momentum (OAM)-based spatial division multiplexing. We discuss methods to generate and detect blue–green optical data-carrying OAM beams as well as various underwater effects, including attenuation, scattering, current, and thermal gradients on OAM beams. Attention is also given to the system performance of high-capacity underwater optical communication links using OAM-based space division multiplexing. The paper closes with a discussion of a digital signal processing (DSP) algorithm to mitigate the inter-mode crosstalk caused by thermal gradients.