The advent of the point-contact transistor is one of the most significant technological achievements in human history with a profound impact on human civilization during the past 75 years. Although the first transistor was made of germanium it was soon replaced by silicon, a material with lower intrinsic carrier mobilities but with a substantially better native oxide. Interestingly, more than two decades ago, germanium was once again considered as a mainstream microelectronic material, since the introduction of high-k dielectrics allowed the consideration of channel materials irrespective of the quality of their native oxide. After about 50 years of limited studies on the defect processes in germanium, the community once again focused on its applicability for mainstream electronic applications. Nevertheless, there are some bottlenecks that need to be overcome, and it was the aim of the present review to discuss the progress in the understanding of the defect processes of Ge.