We review the research on specialty fiber couplers with emphasis placed on the characteristics that make them attractive for biomedical imaging, optical communications, and sensing applications. The fabrication of fiber couplers has been carried out with, in addition to conventional single mode fiber, various specialty fibers such as photonic crystal fiber, double clad fiber, and hole-assisted fiber with a Ge-doped core. For the fiber coupler fabrication, the side polishing and the fused biconical tapered methods have been developed. These specialty fiber couplers have been applied to optical coherence tomography, fluorescence spectroscopy, fiber sensors, and optical communication systems. This review aims to provide a detailed statement on the recent progress and novel applications of specialty fiber couplers.