A microfluidic extracorporeal membrane oxygenator is an advanced extracorporeal life support device designed using microfluidic technology, capable of providing oxygenation support to patients with severe respiratory failure and other pulmonary diseases via extracorporeal circulation. Compared to conventional extracorporeal membrane oxygenators, it features a more superior biomimetic design, demonstrating potential for improved therapeutic outcomes and reduced complications. This review summarizes the research progress of microfluidic extracorporeal membrane oxygenators in terms of hemodynamics, membrane materials, biocompatibility, gas exchange efficiency, and structural design. It analyzes how factors such as blood channel design, material selection and surface modification techniques impact the performance of microfluidic extracorporeal membrane oxygenators, such as biomimetic flow paths minimizing shear stress and endothelial cell linings significantly reducing thrombosis. Finally, the limitations of microfluidic extracorporeal membrane oxygenators are discussed, along with prospects for future development. Innovations are still needed in enhancing biocompatibility, portability, manufacturability, and cost reduction for microfluidic extracorporeal membrane oxygenators.