Sign language machine translation has progressed substantially over the past decade, evolving from isolated sign recognition to end-to-end translation systems. Advances in pose estimation, transformer architectures, and large-scale dataset collection have driven progress, yet challenges remain. Datasets are limited compared to spoken-language resources; evaluation metrics inadequately capture the linguistic quality of output; and models must capture the simultaneous, multi-layered, and three-dimensional structure of sign languages. This manuscript provides a comprehensive review that seeks to balance technical challenges with stakeholder considerations. We examine the linguistic properties that make sign languages computationally unique, trace the evolution of recognition, translation, and production systems, and analyze ongoing technical challenges. Crucially, we address ethical considerations around data governance, community involvement, and appropriate use. Drawing on interdisciplinary perspectives spanning computer vision, sign language linguistics, and deaf studies, our analysis emphasizes that continued progress requires sustained collaboration across these fields and with deaf communities.

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