In principle, karst caves should be avoided as far as possible during pile foundation construction in karst area, but sometimes it is unavoidable. Therefore, the research on the bearing characteristics of pile foundations in karst areas is a problem that must be faced in the development process of pile foundations. This article analyzes the current status of research on the bearing characteristics of pile foundations in karst areas from three aspects: theoretical research, physical experiments, and numerical simulation. The following conclusion is drawn: the existing bearing capacity calculation formulas have insufficient consideration of influencing factors, and subsequent theoretical research should consider the derivation of single pile ultimate bearing capacity calculation formulas under the synergistic influence of multiple factors. The variables in physical model tests are relatively single, and the influence of water on the bearing characteristics of pile foundations is often ignored during the testing process. Subsequent research should focus on the synergistic effect of groundwater and multiple factors. There are few in-situ experiments conducted, and the accuracy of the data obtained through detection needs to be improved. In the future, more in-situ experiments and on-site damage experiments should be carried out to obtain more comprehensive experimental data on the bearing characteristics of pile foundations. In the research related to numerical simulation, most of the cave models are built with standard size, which is inconsistent with the three-dimensional geometric size of the actual stratum cave. The establishment of a more realistic Geometric modeling of the cave is the key development direction in the future.