Abstract: Spallation in ductile metals subjected to intense shock loading originates from multiscale damage evolution governed by the nucleation, growth, and coalescence of microvoids. This review presents a comprehensive overview of the theoretical developments and numerical modeling of void-mediated spallation in ductile metals from the perspective of the underlying mesoscale damage mechanisms. First, the evolution of void nucleation theories is examined, highlighting the transition from classical heterogeneous nucleation associated with second-phase particles to multiple competing mechanisms, including homogeneous nucleation, dislocation-mediated nucleation, and vacancy clustering. Next, the development of void growth models is reviewed, tracing their progression from classical cavitation instability theories to dynamic formulations that incorporate viscoplasticity, micro-inertia, and strain-rate effects. The theoretical descriptions of void coalescence are then summarized, with particular emphasis on localized plastic deformation and damage-induced instability leading to fracture. Building upon these fundamental mechanisms, the review discusses the application and distinctive capabilities of computational approaches for spallation modeling, including molecular dynamics, the finite element method, hydrocodes, phase-field methods, and peridynamics. Particular attention is devoted to the role of multiscale modeling in bridging microscale void evolution and macroscale spall response. Finally, current challenges and future research directions are discussed, including realistic microstructural characterization, dynamic damage mechanisms under extreme strain-rate loading, collective interactions among multiple voids, and robust multiscale coupling strategies. This review provides a unified perspective on the multiscale physics governing ductile metal spallation and offers guidance for the development of predictive damage models and numerical simulation frameworks for high-strain-rate applications.