For the past 20 years, Global Navigation Satellite System reflectometry (GNSS-R) technology has successfully shown its potential for remote sensing of the Earth’s surface, including ocean and land surfaces. It is a multistatic radar that uses the GNSS signals reflected from the Earth’s surface to extract land and ocean characteristics. Because of its numerous advantages such as low cost, multiple signal sources, and all-day/weather and high-spatiotemporal-resolution observations, this new technology has attracted the attention of many researchers. One of its most promising applications is GNSS-R ocean altimetry, which can complement existing techniques such as tide gauging and radar satellite altimetry. Since this technology for ocean altimetry was first proposed in 1993, increasing progress has been made including diverse methods for processing reflected signals (such as GNSS interferometric reflectometry, conventional GNSS-R, and interferometric GNSS-R), different instruments (such as an RHCP antenna with one geodetic receiver, a linearly polarized antenna, and a system of simultaneously used RHCP and LHCP antennas with a dedicated receiver), and different platform applications (such as ground-based, air-borne, or space-borne). The development of multi-mode and multi-frequency GNSS, especially for constructing the Chinese BeiDou Global Navigation Satellite System (BDS-3), has enabled more free signals to be used to further promote GNSS-R applications. The GNSS has evolved from its initial use of GPS L1 and L2 signals to include other GNSS bands and multi-GNSS signals. Using more advanced, multi-frequency, and multi-mode signals will bring new opportunities to develop GNSS-R technology. In this paper, studies of GNSS-R altimetry are reviewed from four perspectives: (1) classifications according to different data processing methods, (2) different platforms, (3) development of different receivers, and (4) our work. We overview the current status of GNSS-R altimetry and describe its fundamental principles, experiments, recent applications to ocean altimetry, and future directions.