Silicon photonics is one of the promising technologies for high-speed optical fiber communications. Among various silicon photonic devices, germanium on silicon avalanche photodiode (Ge/Si APDs) received tremendous attentions because of its superior performance and integration compatibility. In 2016, normal incidence Ge/Si APD demonstrated a NRZ 10−12 sensitivity of −23.5 dBm at 25 Gb/s; more recently, a waveguide-integrated Ge/Si APD receiver presents a 106Gb/s PAM4 sensitivity of −18.9 dBm. These results are best reported performance among all APD-based devices, and these breakthroughs are mainly benefited from Ge/Si APD’s structure and material characteristics. Ge/Si APD adopts a separated charge-absorption-multiplication (SCAM) structure with a pure Ge absorber and an intrinsic Si avalanche layer. Since, Si is one of well-known best avalanche materials with large gain-bandwidth products and low ionization noise ratio, which make Ge/Si APDs demonstrating superior performance at high data rates. Moreover, this Si-based device is manufactured by standard CMOS foundries and is process-compatible with other silicon photonic devices including silicon-based waveguides, demux, hybrid, etc. This advantage simplifies the assembly of photonic systems and makes a large-scale integrated silicon photonic chip possible, which provides compact solutions for high-density communication systems. In this chapter, we review recent progresses on Ge/Si APD structure design, material, and performance.