The piezotronic effect is a coupling effect of semiconductor and piezoelectric properties. The piezoelectric potential is used to adjust the p-n junction barrier width and Schottky barrier height to control carrier transportation. At present, it has been applied in the fields of sensors, human–machine interaction, and active flexible electronic devices. The piezo-phototronic effect is a three-field coupling effect of semiconductor, photoexcitation, and piezoelectric properties. The piezoelectric potential generated by the applied strain in the piezoelectric semiconductor controls the generation, transport, separation, and recombination of carriers at the metal–semiconductor contact or p-n junction interface, thereby improving optoelectronic devices performance, such as photodetectors, solar cells, and light-emitting diodes (LED). Since then, the piezotronics and piezo-phototronic effects have attracted vast research interest due to their ability to remarkably enhance the performance of electronic and optoelectronic devices. Meanwhile, ZnO has become an ideal material for studying the piezotronic and piezo-phototronic effects due to its simple preparation process and better biocompatibility. In this review, first, the preparation methods and structural characteristics of ZnO nanowires (NWs) with different doping types were summarized. Then, the theoretical basis of the piezotronic effect and its application in the fields of sensors, biochemistry, energy harvesting, and logic operations (based on piezoelectric transistors) were reviewed. Next, the piezo-phototronic effect in the performance of photodetectors, solar cells, and LEDs was also summarized and analyzed. In addition, modulation of the piezotronic and piezo-phototronic effects was compared and summarized for different materials, structural designs, performance characteristics, and working mechanisms’ analysis. This comprehensive review provides fundamental theoretical and applied guidance for future research directions in piezotronics and piezo-phototronics for optoelectronic devices and energy harvesting.