With the wide application of Micro-Electro-Mechanical Systems (MEMSs), especially the rapid development of wearable flexible electronics technology, the efficient production of micro-parts with thermoplastic polymers will be the core technology of the harvesting market. However, it is significantly restrained by the limitations of the traditional micro-injection-molding (MIM) process, such as replication fidelity, material utilization, and energy consumption. Currently, the increasing investigation has been focused on the ultrasonic-assisted micro-injection molding (UAMIM) and ultrasonic plasticization micro-injection molding (UPMIM), which has the advantages of new plasticization principle, high replication fidelity, and cost-effectiveness. The aim of this review is to present the latest research activities on the action mechanism of power ultrasound in various polymer micro-molding processes. At the beginning of this review, the physical changes, chemical changes, and morphological evolution mechanism of various thermoplastic polymers under different application modes of ultrasonic energy field are introduced. Subsequently, the process principles, characteristics, and latest developments of UAMIM and UPMIM are scientifically summarized. Particularly, some representative performance advantages of different polymers based on ultrasonic plasticization are further exemplified with a deeper understanding of polymer–MIM relationships. Finally, the challenges and opportunities of power ultrasound in MIM are prospected, such as the mechanism understanding and commercial application.