Microcutting is a precision technology that offers flexible fabrication of microfeatures or complex 3D components with a high machining accuracy and superior surface quality. The technology may offer great potential as well as advantageous process capabilities for the machining of hard-to-cut materials. The geometrical design and dimension of the tool cutting edge is a key factor that determines the size and form accuracy possible in the machined workpiece. Currently, the majority of commercial microtools are scaled-down versions of conventional macrotool design. This approach does not impart optimal performance due to size effects and associated phenomena. Consequently, in-depth analysis and implementation of microcutting mechanics and fundamentals are required to enable successful industrial adaptation in microtool design and fabrication methods. This paper serves as a review of recent microtool designs, materials, and fabrication methods. Analysis of tool performance is discussed, and new approaches and techniques are examined. Of particular focus is tool wear suppression in the machining of hard materials and associated process parameters, including internal cooling and surface patterning techniques. The review concludes with suggestions for an integrated design and fabrication process chain which can aid industrial microtool manufacture.