The burgeoning advances of spatial mode conversion in few-mode fibers emerge as the investigative hotspot in novel structured light manipulation, in that, high-order modes possess a novel fundamental signature of various intensity profiles and unique polarization distributions, especially orbital angular momentum modes carrying with phase singularity and spiral wave front. Thus, control of spatial mode generation becomes a crucial technique especially in fiber optics, which has been exploited to high capacity space division multiplexing. The acousto-optic interactions in few-mode fibers provide a potential solution to tackle the bottleneck of traditional spatial mode conversion devices. Acousto-optic mode conversion controlled by microwave signals brings tremendous new opportunities in spatial mode generation with fast mode tuning and dynamic switching capabilities. Besides, dynamic mode switching induced by acousto-optic effects contributes an energy modulation inside a laser cavity through nonlinear effects of multi-mode interaction, competition, which endows the fiber laser with new functions and leads to the exploration of new physical mechanism. In this review, we present the recent advances of controlling mode switch and generation employing acousto-optic interactions in few-mode fibers, which includes acousto-optic mechanisms, optical field manipulating devices and novel applications of spatial mode control especially in high-order mode fiber lasers.