Over the past two decades, catanionic vesicles fabricated from mixtures of oppositely charged surfactants have attracted substantial attention because of their potential applications in drug delivery. This review focuses on the recent strategies in the development of novel catanionic vesicles, including eliminating excess salt in catanionic mixture systems, increasing the solubility of ion pair amphiphiles, improving drug loading contents, and enhancing the stability of catanionic vesicles. In addition, the gelation behavior of catanionic vesicles caused by polymers is also described.