Electrochemiluminescence (ECL), also called electrogenerated chemiluminescence, is luminescence that is produced by chemical reactions triggered by electrochemical method. ECL imaging is a novel imaging technique, which can simultaneously provide two kinds of signals of both electrochemistry and optical image. Over the past two decades, ECL imaging has been not only a powerful tool for investigating the fundamental scientific questions such as ECL mechanisms and reaction kinetics, but also a versatile analytical technique for detection of a wide range of analytes including small molecules, DNA, proteins, and cells. In the first part of this review, we briefly describe the reaction mechanisms of ECL generation. Then the review focuses on the research progress on the ECL imaging approach. It is basically introduced from the following five aspects: (i) visualization of electroactive sites on surfaces, (ii) imaging analysis at the single-bead and single-cell levels, (iii) array bioanalysis, (iv) multi-color ECL imaging, and (v) paper chip based on ECL imaging. Finally, some perspectives and future directions in this active research area are presented.