The pressure difference between the inlet and outlet of the reactant in fuel cells is called the pressure drop, which is related to the water amount inside the fuel cells. In recent years there have been many studies that used the pressure drop to detect the water content and diagnose water fault of proton exchange membrane fuel cells (PEMFCs). To our knowledge, there has not been a systematic review of these studies. In this paper, the effect variables of pressure drop are reviewed firstly. Then estimations of the theoretical pressure drop are reviewed mainly based on the following four aspects: Bernoulli's equation, two-phase flow multiplier, Darcy's law and artificial intelligence. Afterward, the water fault diagnosis based on the pressure drop using the following six indicators are reviewed: indicator of direct pressure drop, its deviation, frequency, multiplier, the ratio of pressure drop to flow rate and the flooding degree. In addition, the strategies of water fault recovery are also summarized. Finally the merits, demerits and application prospects of pressure drop-based water fault diagnosis are presented. (C) 2016 Elsevier Ltd. All rights reserved.