Gallium (Ga), indium (In), and germanium (Ge) play an important role in the modern high-tech material field. Due to their low content and scattered distribution in the crust, and the increasing demand for these metals in recent years, their supply risks have sharply increased. Therefore, the recycling of these metals is of great significance. In this work, a systematic review was performed using the Web of Science, Scopus, MDPI, Elsevier, and Springer Link databases. The combined terms used for the search were Ga/In/Ge, extraction, separation, and recycling. After a careful evaluation of the titles, abstracts, and full texts, a total of 106 articles were included. This paper briefly describes the resource features of Ga, In, and Ge. After that, the chemical principles, technical parameters, and metal recovery in various extraction and separation methods from monometallic and polymetallic resources are systematically reviewed. Leaching followed by solvent extraction or ion exchange is the main process for Ga, In, and Ge recovery. Although many attempts have been made to separate multiple metals from leaching solutions, highly selective solvents and resins are still the research priority. This review can provide theoretical and technical guidance for the separation of Ga, In, and Ge from various resources.