High strain piezoelectric ceramics are the state-of-the-art materials for high precision, positioning devices. A comprehensive review of the latest developments of the various types of perovskite piezoelectric ceramic systems is presented herein, with special attention given to three promising families of lead-free perovskite ferroelectrics: the barium titanate, alkaline niobate and bismuth perovskites. Included in this review are details of phase transition behavior, strain enhancement approaches, material reliabilities as well as the status of some promising applications. This current review describes both compositional and structural engineering approaches that are intended to achieve enhanced strain properties in perovskite piezoelectric ceramics. The factors that affect the strain behavior of high-strain perovskite piezoelectric ceramics are addressed. The reliability characteristics of these high-strain ferroelectrics as well as the recent approaches to the long-term electrical, thermal and time-stability enhancement are summarized. Several promising applications of high-strain perovskite materials are introduced, which take advantages of their characteristics; examples include high-energy storage, pyroelectric and electro-caloric effect and luminescent properties.