The development of acoustic subsurface atomic force microscopy, which promises three-dimensional imaging with single-digit nanometer resolution by the introduction of ultrasound actuations to a conventional atomic force microscope, has come a long way since its inception in the early 1990s. Recent advances provide a quantitative understanding of the different experimentally observed contrast mechanisms, which paves the way for future applications. In this Perspective, we first review the different subsurface atomic force microscope modalities: ultrasonic force microscopy, atomic force acoustic microscopy, heterodyne force microscopy, mode-synthesizing atomic force microscopy, and near-field picosecond ultrasonic microscopy. Then, we highlight and resolve a debate existing in the literature on the importance of the chosen ultrasound excitation frequencies with respect to the resonance frequencies of the cantilever and the observed contrast mechanisms. Finally, we discuss remaining open problems in the field and motivate the importance of new actuators, near-field picosecond ultrasonics, and integration with other techniques to achieve multi-functional non-destructive three-dimensional imaging at the nanoscale.