Ultrathin solar cells with thicknesses at least 10 times lower than conventional solar cells could offer a unique potential to efficiently convert solar energy into electricity while enabling material savings, shorter deposition times, and improved carrier collection in defective absorber materials. Efficient light absorption and hence high power conversion efficiency could be retained in ultrathin absorbers using light-trapping structures that enhance the optical path. Nevertheless, several technical challenges prevent the realization of a practical device. Here we review the state-of-the-art of c-Si, GaAs and Cu(In,Ga)(S,Se) 2 ultrathin solar cells and compare their optical performances against theoretical light-trapping models. We then address challenges in the fabrication of ultrathin absorber layers and in nanoscale patterning of light-trapping structures and discuss strategies to ensure efficient charge collection. Finally, we provide perspectives to combine photonic and electrical constraints into practical architectures for ultrathin solar cells and identify future research directions and potential applications of ultrathin photovoltaic technologies.