Recent progress in the development of barium strontium titanate thin film varactors for room temperature tunable microwave devices applications is reviewed, with emphasis on efforts towards the improvement in the quality of BST thin films and the fabrication issues crucial for the performance of microwave devices based on BST varactors. The paper provides examples of tunable microwave devices employing BST varactors. Other thin film materials currently competing with BST thin films are discussed. Topics which deserve further investigation are suggested.