ZnO is a typical direct wide-bandgap semiconductor material, which has various morphologies and unique physical and chemical properties, and is widely used in the fields of energy, information technology, biomedicine, and others. The precise design and controllable fabrication of nanostructures have gradually become important avenues to further enhancing the performance of ZnO-based functional nanodevices. This paper introduces the continuous development of patterning technologies, provides a comprehensive review of the optical lithography and laser interference lithography techniques for the controllable fabrication of ZnO nanostructures, and elaborates on the potential applications of such patterned ZnO nanostructures in solar energy, water splitting, light emission devices, and nanogenerators. Patterned ZnO nanostructures with highly controllable morphology and structure possess discrete three-dimensional space structure, enlarged surface area, and improved light capture ability, which realize the efficient carrier regulation, achieve highly efficient energy conversion, and meet the diverse requirements of functional nanodevices. The patterning techniques proposed for the precise design of ZnO nanostructures not only have important guiding significance for the controllable fabrication of complex nanostructures of other materials, but also open up a new route for the further development of functional nanostructures.