Fully conjugated ladder polymers (cLPs), in which all the backbone units on the polymer main-chain are π-conjugated and fused, have attracted great interest owing to their intriguing properties, remarkable chemical and thermal stability, and potential suitability as functional organic materials. The synthesis of cLPs can be, in general, achieved by two main strategies: single-step ladderization and post-polymerization ladderization. Although a variety of synthetic methods have been developed, the chemistry of cLPs must contend with structural defects and low solubility that prevents complete control over synthesis and structural characterization. Despite these challenges, cLPs have been used for a wide range of applications such as organic light emitting diodes (OLEDs) and organic field effect transistors (OFETs), paralleling developments in processing methods. In this perspective, we discuss the background of historical syntheses including the most recent synthetic approaches, challenges related to the synthesis and structural characterization of well-defined cLPs with minimum levels of structural defects, cLPs' unique properties, and wide range of applications. In addition, we propose outlooks to overcome the challenges limiting the synthesis, analysis, and processing of cLPs in order to fully unlock the potential of this intriguing class of organic materials.