Ceramic materials are indispensable in aerospace, energy, and biomedical fields due to their high hardness, heat resistance, and corrosion resistance. However, their inherent brittleness makes it difficult to fabricate complex structures via traditional forming methods. 3D printing provides an effective near-net-shape route, among which Polymer-Derived Ceramics (PDCs) have become a research hotspot owing to binder-free composition, molecular design flexibility, and low-temperature sinterability. This review focuses on photopolymerisation-extrusion coupled moulding as a core strategy to resolve the long-standing trade-off between high precision and low defects in PDC 3D printing. We systematically review the material systems of ceramic precursors, analyze the principles of photopolymerisation-based printing for PDCs, clarify the reaction mechanisms, volumetric shrinkage mechanisms, and extrusion flow behaviors of photopolymerisation-assisted extrusion 3D printing. Emphasis is placed on how coupling mitigates contradictions between precision and defects, improves interlayer bonding, and reduces warpage and cracking. Finally, we summarize key bottlenecks and propose targeted future development directions, providing a clear reference for advancing high-performance ceramic precursor additive manufacturing.