Multilevel converters (MLCs) have emerged as standard power electronic converters for medium voltage high power industrial applications. Owing to dominating device switching losses in high power applications, it is preferable to use low device switching frequency (LDSF) modulation techniques. Then, it is possible to achieve higher device utilization, higher converter efficiency and reduced cooling requirements. However, there exists a trade-off between device switching frequency and harmonic distortion of converter output currents. Therefore, the main challenge for LDSF modulation techniques is to minimize the harmonic distortion of output currents. The goal of this paper is to provide a review of various LDSF modulation techniques proposed in the literature and also discuss in detail about one of the the emerging LDSF control techniques known as synchronous optimal pulsewidth modulation. Finally, challenges to LDSF modulation techniques for emerging multilevel topologies and future trends in applications of MLCs are discussed to motivate further research, to enhance proposed LDSF techniques and to explore for new alternatives.