Ceramic materials are increasingly used in micro-electro-mechanical systems (MEMS) as they offer many advantages such as high-temperature resistance, high wear resistance, low density, and favourable mechanical and chemical properties at elevated temperature. However, with the emerging of additive manufacturing, the use of ceramics for functional and structural MEMS raises new opportunities and challenges. This paper provides an extensive review of the manufacturing processes used for ceramic-based MEMS, including additive and conventional manufacturing technologies. The review covers the micro-fabrication techniques of ceramics with the focus on their operating principles, main features, and processed materials. Challenges that need to be addressed in applying additive technologies in MEMS include ceramic printing on wafers, post-processing at the micro-level, resolution, and quality control. The paper also sheds light on the new possibilities of ceramic additive micro-fabrication and their potential applications, which indicates a promising future.