Fuel cell electric vehicles represent a possible solution to meet the objectives of the energy transition currently underway, which sees the replacement of combustion vehicles with low environmental impact vehicles. For this reason, this market is expected to markedly grow in the coming years. Currently, the most suitable fuel cell technology for both light and heavy transport applications is the Proton Exchange Membrane fuel cell. This review provides a comprehensive description of the state of the art of fuel cell electric vehicles at different levels: vehicle configuration, fuel cell stack, and all the necessary operation systems. The current advantages and limits of the mentioned technology are highlighted, referring to recent studies aimed at optimizing the efficiency of the system and providing future perspectives.