Elite para-cycling needs an overview of relevant and valid research to better understand and improve performance and to develop the sport, using evidence-based decision making. The aim of this scoping review was to 1) provide a research overview of performance and performance determining factors in elite para-cycling to aid coaches and elite athletes, and 2) highlight the gaps in the literature. Four databases (PubMed, SportDiscus, Scopus and MEDLINE) were systematically searched for studies on para-cycling performance and performance factors and 68 relevant studies were identified. Using a conceptual framework based on a power balance model, most studies were categorized as Athlete and Interface focused, while fewer studies focused on Equipment, External conditions, or Impairment. We found several practical matters regarding training, bike fitting, aerodynamics, and prosthetics design to help coaches and elite athletes to improve performance. However, more research is needed in all categories to improve performance and develop the sport. International collaboration among coaches, researchers, and governing bodies is vital to gain valuable research data.