<p>External vibrations such as ground vibrations, acoustic noise, and equipment-induced disturbances can significantly affect precision equipment, making effective vibration isolation essential. Although various vibration isolators are used across industries based on specific application requirements, pneumatic vibration isolators (PVIs) are particularly favored for their superior low-frequency isolation, high stability, and minimal maintenance requirements. This paper offers a comprehensive review of PVIs as a solution to vibration issues in precision equipment. It begins with a comparative analysis of PVIs and other vibration isolation technologies, highlighting their respective advantages and limitations. The paper then discusses the principles, key components, and design considerations of PVIs. Additionally, the necessity of active PVIs is explored, along with advanced control strategies, such as feedback, feedforward, and integrated control methods, to improve isolation performance. Finally, recent advancements and ongoing challenges in active PVIs are examined.</p>