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The current status of high-voltage power semiconductor devices and technologies for high-voltage integrated circuits is reviewed and the new trends in this field are discussed. The paper focuses on the concepts of the novel reduced surface field and state-of-the-art silicon technologies such as high-voltage silicon on insulator, which are expected to play an increasingly important role in power system on-chip manufacturing. Lateral devices such as LDMOSFETs, superjunctions and lateral insulated gate bipolar transistors are discussed. The paper also touches on emerging technologies such as unified MEMS-IC for enhanced breakdown capability and isolation. Finally, an overview of the fierce fight of technology survival in terms of specific on-state resistance against breakdown voltage is given.