Emissions of nitrogen oxides (NO x ) from combustion systems remain a lingering environmental issue, being these species either greenhouse gases or acid rain precursors. Moderate or Intense Low-oxygen Dilution (MILD) combustion can reduce the emissions of NO x thanks to its characteristic features (i.e., homogeneous reaction zones, reduced temperature peaks, diluted mixtures of reactants) that influence and change the main chemical pathways of NO x formation. A summary of the relevant routes of formation and destruction of NO x in MILD combustion is presented in this review, along with the identification of the sources of uncertainty that prevent reaching an overall consensus in the literature about the dominant NO x chemical pathway in MILD regime. Computational Fluid Dynamics (CFD) approaches are essential tools for investigating the critical phenomena occurring in MILD combustion and the design of pollutant-free turbulent combustion systems. This paper provides an outline of the modeling approaches employed in CFD simulations of turbulent combustion systems to predict NO x emissions in MILD conditions. An assessment of the performances of selected models in estimating NO x formation in a lab-scale MILD combustion burner is then presented, followed by a discussion about relevant modeling issues, perspectives and opportunities for future research.