The development of MEMS actuators is rapidly evolving and continuously new progress in terms of efficiency, power and force output is reported. Pneumatic and hydraulic are an interesting class of microactuators that are easily overlooked. Despite the 20 years of research, and hundreds of publications on this topic, these actuators are only popular in microfluidic systems. In other MEMS applications, pneumatic and hydraulic actuators are rare in comparison with electrostatic, thermal or piezo-electric actuators. However, several studies have shown that hydraulic and pneumatic actuators deliver among the highest force and power densities at microscale. It is believed that this asset is particularly important in modern industrial and medical microsystems, and therefore, pneumatic and hydraulic actuators could start playing an increasingly important role. This paper shows an in-depth overview of the developments in this field ranging from the classic inflatable membrane actuators to more complex piston-cylinder and drag-based microdevices.