In recent years, with the appearance of the triboelectric nanogenerator (TENG), there has been a wave of research on small energy harvesting devices and self-powered wearable electronics. Hydrogels—as conductive materials with excellent tensile properties—have been widely focused on by researchers, which encouraged the development of the hydrogel-based TENGs (H-TENGs) that use the hydrogel as an electrode. Due to the great feasibility of adjusting the conductivity and mechanical property as well as the microstructure of the hydrogels, many H-TENGs with excellent performance have emerged, some of which are capable of excellent outputting ability with an output voltage of 992 V, and self-healing performance which can spontaneously heal within 1 min without any external stimuli. Although there are numerous studies on H-TENGs with excellent performance, a comprehensive review paper that systematically correlates hydrogels’ properties to TENGs is still absent. Therefore, in this review, we aim to provide a panoramic overview of the working principle as well as the preparation strategies that significantly affect the properties of H-TENGs. We review hydrogel classification categories such as their network composition and their potential applications on sensing and energy harvesting, and in biomedical fields. Moreover, the challenges faced by the H-TENGs are also discussed, and relative future development of the H-TENGs are also provided to address them. The booming growth of H-TENGs not only broadens the applications of hydrogels into new areas, but also provides a novel alternative for the sustainable power sources.