One of the key challenges in the field of silicon photonics remains the development of compact integrated light sources. In one approach, rare-earth-doped glass microtoroid and microdisk lasers have been integrated on silicon and exhibit ultra-low thresholds. However, such resonator structures are isolated on the chip surface and require an external fiber to couple light to and from the cavity. Here, we review our recent work on monolithically integrated rare-earth-doped aluminum oxide microcavity lasers on silicon. The microlasers are enabled by a novel high-Q cavity design, which includes a co-integrated silicon nitride bus waveguide and a silicon dioxide trench filled with rare-earth-doped aluminum oxide. In passive (undoped) microresonators we measure internal quality factors as high as 3.8 × 105 at 0.98 µm and 5.7 × 105 at 1.5 µm. In ytterbium, erbium, and thulium-doped microcavities with diameters ranging from 80 to 200 µm we show lasing at 1.0, 1.5 and 1.9 µm, respectively. We observe sub-milliwatt lasing thresholds, approximately 10 times lower than previously demonstrated in monolithic rare-earth-doped lasers on silicon. The entire fabrication process, which includes post-processing deposition of the gain medium, is silicon-compatible and allows for integration with other silicon-based photonic devices. Applications of such rare earth microlasers in communications and sensing and recent design enhancements will be discussed.