The annular centrifugal extractor (ACE) integrates mixing and separation. It has been widely used in many industrial fields because of its low residence time, compact structure, and high mass transfer efficiency. Most of the literature has focused on flow instabilities, flow visualization, and computational fluid dynamics simulations. More recently, research on hydrodynamic behavior and structural optimization has received widespread attention. With the development of ACE technology, applications have been broadened into several new areas. Hence, this paper reviews research progress regarding ACE in terms of hydrodynamic characteristics and the structural improvements. The latest applications covering hydrometallurgy, nuclear fuel reprocessing, bio-extraction, catalytic reaction, and wastewater treatment are presented. We also evaluate future work in droplet breakup and coalescence mechanisms, structural improvements specific to different process requirements, scaling-up methods, and stability and reliability after scaling-up.