Micro electro mechanical systems (MEMS) accelerometers are widespread in various applications like inertial sensing applications, indoor robotic navigation, microsurgery, volcanology and also in defence applications. Though various sensing mechanisms are available piezoresistive is still popular due to its simple fabrication and packaging techniques. An incessant development has been made in the growth of piezoresistive accelerometers which has led to various innovations in design, fabrication, packaging and testing. This paper presents a comprehensive review on packaging in piezoresistive accelerometers, different levels in packaging and various techniques adopted in design. © IAEME Publication.