The microbial fuel cell (MFC) technology offers sustainable solutions for distributed power systems and energy positive wastewater treatment, but the generation of practically usable power from MFCs remains a major challenge for system scale up and application. Commonly used external resistors will not harvest any usable energy, so energy-harvesting circuits are needed for real world applications. This review summarizes, explains, and discusses the different energy harvesting methods, components, and systems that can extract and condition the MFC energy for direct utilization. This study aims to assist environmental scientists and engineers to gain fundamental understandings of these electronic systems and algorithms, and it also offers research directions and insights on how to overcome the barriers, so the technology can be further advanced and applied in larger scale.