Miniaturized electrochemical systems integrated into microfluidic flow devices have been an active research field the last couple of decades. This has resulted in many advanced microfluidic platforms for the conversion and detection of chemicals. The development is partly driven by the increased access to and decreased cost of fabrication. In the design of microfluidic electrochemical cells, several aspects need to be handled, such as the accurate control of potential, electrolyte flow, pH, pressure, and temperature. This can be further complicated by integrating photon traffic for spectro(electro)chemical detection. Here, a comprehensive review of recent advances and approaches to the design of microfluidic flow devices for detection is presented, first dealing with the design of electrodes and flow pathways, then highlighting some common challenges and how these have been dealt with in the literature. This work aims to be a guide for researchers in the design of microfluidic electrochemical systems for detection of chemical species.