A flexure hinge is a major component in designing compliant mechanisms that offers unique possibilities in a wide range of application fields in which high positioning accuracy is required. Although various flexure hinges with different configurations have been successively proposed, they are often designed based on designers’ experiences and inspirations. This study presents a systematic method for topological optimization of flexure hinges by using the level set method. Optimization formulations are developed by considering the functional requirements and geometrical constraints of flexure hinges. The functional requirements are first constructed by maximizing the compliance in the desired direction while minimizing the compliances in the other directions. The weighting sum method is used to construct an objective function in which a self-adjust method is used to set the weighting factors. A constraint on the symmetry of the obtained configuration is developed. Several numerical examples are presented to demonstrate the validity of the proposed method. The obtained results reveal that the design of a flexure hinge starting from the topology level can yield more choices for compliant mechanism design and obtain better designs that achieve higher performance.