Pico-technology fabrication techniques provide a novel precision engineering breakthrough for manipulating materials and structures at the picometer scale (10^-12 meters). Such atomic precision exceeds conventional nanotechnology, enabling ultra-miniaturized, high-performance electronic, photonic, and biomedical devices. The most commonly used pico-technology fabrication techniques include Atomic Layer Deposition (ALD), Molecular Beam Epitaxy (MBE), Electron Beam Lithography (EBL), Focused Ion Beam (FIB) milling, and Scanning Tunneling Microscopy (STM)-assisted assembly. These tools allow atomic level control of material deposition, structuring, and characterization, enabling unprecedented precision and performance enhancement in next-generational semiconductors, quantum devices, nanosensors, and energy-efficient devices. Moreover, using artificial intelligence and machine learning in pico-fabrication processes has further enhanced pico-fabrication efficiency and scalability by optimizing material discovery, defect detection, and process automation. Some crucial fields in pico-fabrication include quantum computing, ultra-dense transistor scaling in semiconductor technology, high-speed optical communication in nanophotonic, ultra-sensitive biosensors, and active drug cells in biomedical engineering applications. The potential to revolutionize prevention and treatment, the cost-effectiveness, reproducibility, and population-scale implementation of this approach in practice remain crucial areas of investigation. Significant advances in hybrid fabrication technologies and process optimization associated with the novel materials will also be used in the Technology to the next level. The increasing demand for atomic-scale precision and pico-fabrication will be an essential sustained of the future in science and technology, with their capabilities in computing, healthcare, energy, and advanced material science. This chapter discusses the fabrication techniques in Pico-technology.