Traditional methods of tissue closure, such as sutures and staples, have long been the gold standard in surgery. However, they have major drawbacks, such as the body's reaction to foreign materials and the difficulty of the technical aspects of minimally invasive procedures. Energy-based tissue fusion (EBTF) technology is a revolutionary alternative that uses energy to produce autologous tissue sealing. This review aims to provide a comprehensive analysis of the biophysical principles, technological evolution, and clinical applications of current EBTF technologies and related devices. The fundamental mechanisms of EBTF technologies are investigated, with a focus on collagen denaturation and cross-linking induced by different energy modalities such as radiofrequency (RF) current, ultrasound, and laser. Three representative systems are critically evaluated: the impedance-controlled bipolar system (LigaSureTM), the ultrasonic coagulating shears (HarmonicTM), and the hybrid ultrasonic-bipolar device (ThunderbeatTM). Their performance is compared in terms of vessel sealing efficacy, thermal spread, operative time, and complication rates across various surgical specialties. The clinical evidence indicates that the primary advantage of RF device lies in safety, whereas the ultrasonic devices offer reduced lateral thermal damage, and the hybrid device demonstrate superior versatility and procedural speed. The review concludes by identifying future trends, including the integration of artificial intelligence and robotic platforms, which promise to further enhance the safety and precision of surgical energy devices.