Single-atom catalysts (SACs) have emerged as a new frontier in areas such as electrocatalysis, photocatalysis, and enzymatic catalysis. Aided by recent advances in the synthetic methodologies of nanomaterials, atomic characterization technologies, and theoretical calculation modeling, various SACs have been prepared for a variety of catalytic reactions. To meet the requirements of SACs with distinctive performance and appreciable selectivity, much research has been carried out to adjust the coordination configuration and electronic properties of SACs. This concept summarizes the latest advances in the experimental and computational efforts aimed at tuning the axial coordination of SACs. Series of atoms, functional groups or even macrocycles are oriented into the atomic metal center, and how this affects the electrocatalytic performance is also reviewed. Finally, this concept presents perspectives for the further precise design, preparation and in-situ detection of axially coordinated SACs.