The femtosecond laser directwriting technique has been extensively explored for fabricating threedimensional optical waveguide devices in transparent, hard, and fragile materials owing to its ultrashort pulse duration, ultrahigh peak power, high manufacturing precision, and efficiency. Recently, there is a growing interest in producing optical waveguide devices in flexible polydimethylsiloxane (PDMS) using the femtosecond laser directwriting technique. This study reviewed the latest development in femtosecond laser directwriting Type -I optical waveguide devices in flexible PDMS, focusing on three aspects: the basic principle of different kinds of optical waveguide written by femtosecond laser; materials design, directwriting principle, and processing technology of Type -I optical waveguide directlywritten by femtosecond laser in flexible PDMS in last five years; and research progress of the application of the optical waveguide devices in flexible PDMS based on femtosecond laser directwriting technique for diffraction gratings and cochlear endoscope.Finally, herein, the research progress in this field is summarized, analyzed and concluded, and the future research, application, and developmental direction are outlined.