Micro elastofluidics is a transformative branch of microfluidics, leveraging the fluid–structure interaction (FSI) at the microscale to enhance the functionality and efficiency of various microdevices. This review paper elucidates the critical role of advanced computational FSI methods in the field of micro elastofluidics. By focusing on the interplay between fluid mechanics and structural responses, these computational methods facilitate the intricate design and optimisation of microdevices such as microvalves, micropumps, and micromixers, which rely on the precise control of fluidic and structural dynamics. In addition, these computational tools extend to the development of biomedical devices, enabling precise particle manipulation and enhancing therapeutic outcomes in cardiovascular applications. Furthermore, this paper addresses the current challenges in computational FSI and highlights the necessity for further development of tools to tackle complex, time-dependent models under microfluidic environments and varying conditions. Our review highlights the expanding potential of FSI in micro elastofluidics, offering a roadmap for future research and development in this promising area.