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Blood is the most widely used matrix for biomonitoring of persistent organic pollutants (POPs). It is assumed that POPs are homogenously distributed within body lipids at steady state; however, the variability underlying the partitioning of POPs between fat compartments is poorly understood. Hence, the objective of this study was to review the state of the science about the relationships of POPs between adipose tissue and serum in humans. We conducted a narrative literature review of human observational studies reporting concentrations of POPs in paired samples of adipose tissue with other lipid-based compartments (e.g., serum lipids). The searches were conducted in SCOPUS and PUBMED. A meta-regression was performed to identify factors responsible for variability. All included studies reported high variability in the partition coefficients of POPs, mainly between adipose tissue and serum. The number of halogen atoms was the physicochemical variable most strongly and positively associated with the partition ratios, whereas body mass index was the main biological factor positively and significantly associated. To conclude, although this study provides a better understanding of partitioning of POPs to refine physiologically based pharmacokinetic and epidemiological models, further research is still needed to determine other key factors involved in the partitioning of POPs.