Piezocatalysis has attracted significant attention in recent years due to its ability to convert mechanical energy into chemical energy for clean energy production and environmental treatment. Despite its potential, piezocatalysis is still in its early stages with limited catalytic efficiency and low conversion efficiency of mechanical to chemical energy, restricting its wider application. Oxygen vacancies in oxide piezoelectric materials have been found to affect the piezocatalytic efficiency from many perspectives. This review systematically discusses the role of oxygen vacancies in modulating the piezoresponse, influencing carrier dynamics, and serving as active centers in surface catalysis. Moreover, an overview of the current advancements in oxygen defect engineering within piezocatalytic systems is provided. The paper also highlights the existing challenges and proposes future directions for research in this field.