In recent years, close attention has been paid to microbial flocculants because of their advantages, including safety to humans, environmental friendliness, and acceptable removal performances. In this review, the preparation methods of microbial flocculants were first reviewed. Then, the performances of bioflocculants in the removal of suspended solids, heavy metals, and other organic pollutants from various types of wastewater were described and commented, and the removal mechanisms, including adsorption bridging, charge neutralization, chemical reactions, and charge neutrality, were also discussed. The future research needs on microbial flocculants were also proposed. This review would lead to a better understanding of current status, challenges, and corresponding strategies on microbial flocculants and bioflocculation in wastewater treatment.