The contamination of air, water and soil by heavy metal ions is one of the most serious problems plaguing the environment. These metal ions are characterized by a low biodegradability and high chemical stability and can affect humans and animals, causing severe diseases. In addition to the typical analysis methods, i.e., liquid chromatography (LC) or spectrometric methods (i.e., atomic absorption spectroscopy, AAS), there is a need for the development of inexpensive, easy-to-use, sensitive and portable devices for the detection of heavy metal ions at the point of interest. To this direction, microfluidic and lab-on-chip (LOC) devices fabricated with novel materials and scalable microfabrication methods have been proposed as a promising approach to realize such systems. This review focuses on the recent advances of such devices used for the detection of the most important toxic metal ions, namely, lead (Pb), mercury (Hg), arsenic (As), cadmium (Cd) and chromium (Cr) ions. Particular emphasis is given to the materials, the fabrication methods and the detection methods proposed for the realization of such devices in order to provide a complete overview of the existing technology advances as well as the limitations and the challenges that should be addressed in order to improve the commercial uptake of microfluidic and LOC devices in environmental monitoring applications.