Although platinum-based catalysts are highly effective for the oxygen reduction reaction (ORR) in proton exchange membrane fuel cells (PEMFCs), their high cost and scarcity limit large-scale commercialization. As a result, platinum group metal-free catalysts—particularly Fe-N-C materials—have received increasing attention as promising alternatives. Despite significant progress, no platinum-group metal-free (PGM-free) catalyst has yet matched the performance and durability of commercial Pt/C in acidic media. Recent advances in synthesis strategies, however, have led to notable improvements in the activity, stability, and active site density of Fe-N-C catalysts. This review highlights key synthesis approaches, including pyrolysis, MOF-derived templates, and cascade anchoring, and discusses how these methods contribute to improved nitrogen coordination, electronic structure modulation, and active site engineering. The continued refinement of these strategies, alongside improved catalyst screening techniques, is essential for closing the performance gap and enabling the practical deployment of non-PGM catalysts in PEMFC technologies.