All the information regarding the distribution of karst caves sometimes cannot be fully reflected by means such as drilling, electrical prospecting and seismic exploration. Even with optimized design, it remains difficult to avoid the situation where pile foundations are constructed above karst caves and have to penetrate through them. The current research status of the bearing characteristics of pile foundations penetrating karst caves was analyzed from aspects like theoretical calculation, numerical simulation, indoor experiment, on-site experiment and karst cave filling materials. The following conclusions are obtained. When calculating the bearing capacity of pile foundations penetrating karst caves, the influence of the three-dimensional geometric dimensions of karst caves on the bearing characteristics of pile foundations must be comprehensively taken into account. The accuracy of parameter selection needs to be enhanced, the load transfer mechanism should be thoroughly understood, and theoretical models considering the influence of multiple factors comprehensively should be developed. In on-site experiments, emphasis should be placed on the accuracy and comprehensiveness of data collection. Unified standards and specifications ought to be established to enhance the representativeness, universality and applicability of the experimental results, thereby providing references for similar issues. Indoor models have investigated the influence law of the shape of karst caves on the bearing characteristics of pile foundations, analyzed the interaction mechanism between pile foundations and the roof of karst caves, and disclosed the stress characteristics and failure modes of pile foundations when penetrating karst caves. However, the shapes of simulated karst caves are relatively regular and single, and the influence of groundwater, temperature and the filling of karst caves on the bearing mechanism of pile foundations is rarely considered. The numerical simulation method is capable of simulating the bearing characteristics of pile foundations under complex stress states with different karst cave shapes, different pile types and different construction conditions. Nevertheless, the accuracy of parameter selection and simulation results requires improvement. The establishment of real geometric models of karst caves is a crucial development direction in the future. The research and optimization of karst cave filling materials are rather idealized, and their application under complex geological conditions is rather difficult. They usually exhibit performances that do not meet expectations. The research and development of karst cave filling materials should fully consider the adverse effects of special geological conditions, temperature changes and the chemical corrosion effect of the water environment in karst caves on the properties of filling materials.