Piezoelectric accelerometers have been widely used because of their large range, simple structure, stable performance, and other advantages. With the improvement of science and technology, the application field is expanding, but there are still some problems in high-temperature environments and low-frequency vibration conditions. Under high-temperature environments, the piezoelectric material will undergo depolarization or resistance change, resulting in sensor failure. Aerospace instruments, water conservancy platforms, and other fields require high-precision instruments with vibration amplitudes of the order of a few microns in the range of 0.01–1 Hz, which require low-frequency and ultra-low-frequency sensors for the measurements. Therefore, how to increase the operating temperature and reduce the noise of piezoelectric accelerometers has become a problem that needs to be solved. This paper reviews the structure, principle, application range, and material selection of piezoelectric components of different types of piezoelectric accelerometers and summarizes the current problems and future research priorities.