Hydrogen storage in general is an indispensable prerequisite for the introduction of a hydrogen energy-based infrastructure. In this respect, high-pressure metal hydride (MH) tank systems appear to be one of the most promising hydrogen storage techniques for automotive applications using proton exchange membrane (PEM) fuel cells. These systems bear the potential of achieving a beneficial compromise concerning the comparably large volumetric storage density, wide working temperature range, comparably low liberation of heat, and increased safety. The debatable term “unstable metal hydride” is used in the literature in reference to metal hydrides with high dissociation pressure at a comparably low temperature. Such compounds may help to improve the merits of high-pressure MH tank systems. Consequently, in the last few years, some materials for possible on-board applications in such tank systems have been developed. This review summarizes the state-of-the-art developments of these metal hydrides, mainly including intermetallic compounds and complex hydrides, and offers some guidelines for future developments. Since typical laboratory hydrogen uptake measurements are limited to 200 bar, a possible threshold for defining unstable hydrides could be a value of their equilibrium pressure of peq > 200 bar for T < 100 °C. However, these values would mark a technological future target and most current materials, and those reported in this review, do not fulfill these requirements and need to be seen as current stages of development toward the intended target. For each of the aforementioned categories in this review, special care is taken to not only cover the pioneering and classic research but also to portray the current status and latest advances. For intermetallic compounds, key aspects focus on the influence of partial substitution on the absorption/desorption plateau pressure, hydrogen storage capacity and hysteresis properties. For complex hydrides, the preparation procedures, thermodynamics and theoretical calculation are presented. In addition, challenges, perspectives, and development tendencies in this field are also discussed.