Non-destructive measurements of high aspect ratio microscale features, especially those with internal geometries such as micro-holes, remain a challenging metrology problem that is increasing in difficulty due to the increasing requirement for more complexity and higher tolerances in such structures. Additionally, there is a growing use of functional surface texturing for improving characteristics such as heat transfer and wettability. As a result, measurement techniques capable of providing dimensional form and surface finish for these features are of intense interest. This review explores the state-of-the-art inspection methodologies compatible with high-aspect-ratio structures and their suitability for extracting three-dimensional surface data based on identified high-aspect ratio structure types. Here, the abilities, limitations, challenges, and future requirements for the practical implementation and acceptance of these measurement techniques are presented.