This　study　provides　a　comprehensive　review　of　the　state-of-the-art　in　seismic　design　and　resilience　for　girder　bridges　with　tall　piers,　a　critical　infrastructure　component　in　mountainous　and　canyon　regions.　With　the　increasing　complexity　of　topographical　challenges,　especially　in　southwest　China,　tall　piers　exceeding　40　m　have　become　indispensable　in　navigating　these　spatial　constraints.　However,　their　significant　mass　distribution　and　high　height-to-width　ratios　introduce　complex　seismic　behavior,　making　them　vulnerable　to　earthquake-induced　damages.　This　study　synthesizes　various　definitions　of　tall　piers　across　seismic　design　codes　and　explores　the　unique　seismic　behavior　characteristics　that　classify　these　structures　as　irregular.　We　critically　evaluate　the　efficacy　of　conventional　seismic　ductility　and　isolation　systems,　underscored　by　case　studies　of　observed　damages　in　major　earthquakes.　Innovations　in　seismic-resistant　systems,　including　the　adoption　of　Concrete　Filled　Steel　Tube　(CFST)　tall　piers　and　Rocking　Self-centering　(RSC)　systems,　are　highlighted　for　their　potential　to　enhance　the　durability　and　recovery　capabilities　of　girder　bridges　post-earthquake.　Despite　advancements,　challenges　in　post-earthquake　rehabilitation,　theoretical　frameworks,　and　cost-effectiveness　persist,　necessitating　further　research.　This　study　concludes　by　identifying　future　research　directions　aimed　at　extending　innovative　RSC　technology　to　girder　bridges　with　tall　piers,　improving　seismic　performance　assessments,　and　refining　the　quantification　of　higher-mode　effects.　Through　a　systematic　review,　this　study　aims　to　pave　the　way　for　further　innovation　and　application　of　advanced　seismic-resistant　technologies　in　the　construction　of　girder　bridges　with　tall　piers,　enhancing　their　resilience　against　seismic　threats.