Polyhydroxyalkanoates (PHA) are a family of polyesters consisting of over 150 chiral hydroxyalkanoic acids (HA). This paper reviews the physiological functions of (R)-3-hydroxybutyric acid (3HB) and (R)-4-hydroxybutyric acid and summarizes the technologies developed to produce various HA [3HB, (R)-3-hydroxyoctanoic acid, (R)-3-hydroxydecanoic acid, etc.] and the applications of chiral HA. Their outlooks and perspectives are discussed.