Various kinds of controlled microtopographies can promote osteogenic differentiation of mesenchymal stem cells (MSCs), such as microgrooves, micropillars, and micropits. However, the optimal shape, size, and mechanism remain unclear. In this review, we summarize the relationship between the parameters of different microtopographies and the behavior of MSCs. Then, we try to reveal the potential mechanism between them. The results showed that the microgrooves with a width of 4–60 μm and ridge width <10 μm, micropillars with parameters less than 10 μm, and square micropits had the full potential to promote osteogenic differentiation of MSCs, while the micromorphology of the same size could induce larger focal adhesions (FAs), well-organized cytoskeleton, and superior cell areas. Therefore, such events are possibly mediated by microtopography-induced mechanotransduction pathways.