3D printing has revolutionized the way of manufacturing with a huge impact on various fields, in particular biomedicine. Vat photopolymerization‐based 3D printing techniques such as stereolithography (SLA) and digital light processing (DLP) attract considerable attention owing to their superior print resolution, relatively high speed, low cost, and flexibility in resin material design. As one key element of the SLA/DLP resin, photoinitiators or photoinitiating systems have experienced significant development in recent years, in parallel with the exploration of 3D printing (macro)monomers. The design of new photoinitiating systems cannot only offer faster 3D printing speed and enable low‐energy visible light fabrication, but also can bring new functions to the 3D printed products and even generate new printing methods in combination with advanced optics. This review evaluates recent trends in the development and application of advanced photoinitiators and photoinitiating systems for vat photopolymerization 3D printing, with a wide range of small molecules, polymers, and nanoassemblies involved. Personal perspectives on the current limitations and future directions are eventually provided.