A precise cable drive system is a flexible friction transmission method that utilizes the power transmitted from drive capstans to a driven pulley through a proper preloaded transmission medium. It has many advantages, such as flexible layout and high precision, besides being lightweight. It is widely used in many dexterous precise electromechanical devices and servomechanisms. The progress in the applicability of the precise cable drive is summarized in the aspects of precision pointing mechanism, harmonious robot, haptic interface mechanism, running robot, dexterous hand and endoscopic surgery. Next, the urgent issues of the basic theory and application research are dealt with, including studies on transmission mechanism, applied studies on servo systems, and engineering design methods for typical applications. Eventually, some suggestions regarding further research on theory analysis and engineering design technology of the precise cable drive system have been put forward.