This article discusses a control problem of underactuated autonomous surface vehicles (ASVs) subject to internal/external uncertainties, input saturations, and actuator faults, and proposes a novel event-triggered adaptive PID fault-tolerant (ETAPID-FT) control solution. To resolve the design difficulty caused by the underactuated feature, a standard multivariate integral cascade form regarding the mathematical model of underactuated ASVs is established. And then, to facilitate the implementation of PID-based design framework, the nonsmooth actuator saturation nonlinearity caused by the saturation constraint is represented by a smooth saturation model. In the control design, considering full features of the actuator fault and smooth function, an indirect neural approximation with single-parameter-leaning technique is developed, which endows the function of self-tuning control gain for the control solution. To relieve the mechanical wear of actuator, an improved event-triggered protocol by implanting a decreasing function of ASV’s position error is proposed. Moreover, the theoretical results show that the proposed ETAPID-FT control solution can guarantee the boundedness of all the signals in the closed-loop control system of underactuated ASVs. Finally, the validity of the developed control solution is confirmed by the simulation and comparative results