Due to their high electromechanical coupling and energy density properties, ultrathin piezoelectric films have recently been intensively studied as key materials for the construction of miniaturized energy transducers, and in this paper we summarize the research progress. At the nanoscale, even a few atomic layers, ultrathin piezoelectric films have prominent shape anisotropic polarization, that is, in-plane polarization and out-of-plane polarization. In this review, we first introduce the in-plane and out-of-plane polarization mechanism, and then summarize the main ultrathin piezoelectric films studied at present. Secondly, we take perovskite, transition metal dichalcogenides, and Janus layers as examples to elaborate the existing scientific and engineering problems in the research of polarization, and their possible solutions. Finally, the application prospect of ultrathin piezoelectric films in miniaturized energy converters is summarized.