This work presents a short review of the current research on the acousto-optic mechanism applied to optical fibers. The role of the piezoelectric element and the acousto-optic modulator in the excitation of flexural and longitudinal acoustic modes in the frequency range up to 1.2 MHz is highlighted. A combination of the finite elements and the transfer matrix methods is used to simulate the interaction of the waves with Bragg and long period gratings. Results show a very good agreement with experimental data. Recent applications such as the writing of gratings under the acoustic excitation and a novel viscometer sensor based on the acousto-optic mechanism are discussed.