Fluorescent molecules are versatile nanoscale emitters that enable detailed observations of biophysical processes with nanoscale resolution. Because they are well-approximated as electric dipoles, imaging systems can be designed to visualize their 3D positions and 3D orientations, so-called dipole-spread function (DSF) engineering, for 6D super-resolution single-molecule orientation-localization microscopy (SMOLM). We review fundamental image-formation theory for fluorescent di-poles, as well as how phase and polarization modulation can be used to change the image of a dipole emitter produced by a microscope, called its DSF. We describe several methods for designing these modulations for optimum performance, as well as compare recently developed techniques, including the double-helix, tetrapod, crescent, and DeepSTORM3D learned point-spread functions (PSFs), in addition to the tri-spot, vortex, pixOL, raPol, CHIDO, and MVR DSFs. We also cover common imaging system designs and techniques for implementing engineered DSFs. Finally, we discuss recent biological applications of 6D SMOLM and future challenges for pushing the capabilities and utility of the technology.