Micro-electrical discharge machining (micro-EDM) is a widely used technique for producing complex geometries with high precision in metals, including nitinol (NiTi) alloys. This review provides insights into the process parameters, electrode material, and surface integrity for the micro-EDM of NiTi. The pulse duration, pulse frequency, and discharge current are critical parameters that affect the machining performance of NiTi. Copper-tungsten and tungsten carbide are commonly used electrode materials for micro-EDM of NiTi. The surface integrity of the machined surface is an essential consideration for biomedical applications. There is a pressing need for the investigation of the microstructure and phase transformation of NiTi after micro-EDM to understand the influence of machining on the material properties. This review provides valuable information for researchers and engineers to optimize the machining performance and improve the material properties of NiTi for biomedical applications.