This paper reviews the 40-year evolution and application of the magnetic suspension balance (MSB) and discusses some challenging issues of the technique. An MSB, as defined herein, is a magnetic suspension coupling (MSC) connected to an analytical balance. With an MSC, an object can be weighed in a different environment than the balance itself, making it possible for contactless weighing. Over the past 40 years, the MSB has been commonly used in research areas requiring accurate object weighings, notably gas density measurements by MSB-based densimeters and gas adsorption measurements by MSB-based sorption analyzers. More than 15 MSB-based densimeters have been built to date; these are generally called two-sinker densimeter and single-sinker densimeter. They have produced highly accurate density data of many pure fluids and fluid mixtures. These data serve as the basis for the development of reference equations of state, which play an essential role in various industrial and scientific areas. Moreover, such systems are central to the metrology program of many countries. The MSB technique is also very successful in adsorption science: more than 85 MSB-based sorption analyzers have been set up in over 20 countries. The number of new MSB-based sorption analyzers, and peer-reviewed publications resulting from them, are both increasing exponentially since 2004. They have produced highly reliable gas adsorption data at high pressures for many applications, mainly in the energy and environmental sectors. Although further development of innovative instruments based on the MSB is threatened by the proprietary nature of MSB technology, the development will continue, e.g., toward cryogenic measurements and a more compact design.