Origami has emerged as a powerful mechanism for designing functional foldable and deployable structures. Among various origami patterns, a large class of origami exhibits rotational symmetry, which possesses the advantages of elegant geometric shapes, axisymmetric contraction/expansion, and omnidirectional deployability, etc. Due to these merits, origami with rotational symmetry has found widespread applications in various engineering fields such as foldable emergency shelters, deformable wheels, deployable medical stents, and deployable solar panels. To guide the rational design of origami-based deployable structures and functional devices, numerous works in recent years have been devoted to understanding the geometric designs and mechanical behaviors of rotationally symmetric origami. In this review, we classify origami structures with rotational symmetry into three categories according to the dimensional transitions between their deployed and folded states as three-dimensional to three-dimensional, three-dimensional to two-dimensional, and two-dimensional to two-dimensional. Based on these three categories, we systematically review the geometric designs of their origami patterns and the mechanical behaviors during their folding motions. We summarize the existing theories and numerical methods for analyzing and designing these origami structures. Also, potential directions and future challenges of rotationally symmetric origami mechanics and applications are discussed. This review can provide guidelines for origami with rotational symmetry to achieve more functional applications across a wide range of length scales.