This review discusses the development and application of microfluidic systems that utilize surface-enhanced Raman scattering (SERS) for disease diagnosis. SERS detection technology, combined with microfluidics, offers high sensitivity and precise control of small liquid samples, expanding analytical capabilities beyond traditional methods. The review explores various SERS-based microfluidic devices developed over the past two decades, including continuous-flow channels, microarray-embedded channels, droplet microfluidic channels, digital droplet channels, and gradient microfluidic channels. These devices are applied in biomedical diagnostics, enabling the simultaneous detection of multiple targets and improving sensitivity and reproducibility. The review highlights the advantages of SERS over conventional detection methods, such as higher sensitivity, better multiplex detection, and improved reproducibility. It also addresses challenges in SERS detection, such as the need for uniform nanoparticle aggregation and the limitations of small detection volumes. The review emphasizes the potential of SERS-based microfluidic technology for clinical diagnostics, including rapid and accurate detection of pathogens and biomarkers. The study concludes that further development is needed to translate these technologies into practical applications, including miniaturization of Raman spectrophotometers, improved flow control, and integration of machine learning for enhanced diagnostic accuracy. The review provides a comprehensive overview of the current state of SERS-based microfluidic devices and their potential for future clinical applications.This review discusses the development and application of microfluidic systems that utilize surface-enhanced Raman scattering (SERS) for disease diagnosis. SERS detection technology, combined with microfluidics, offers high sensitivity and precise control of small liquid samples, expanding analytical capabilities beyond traditional methods. The review explores various SERS-based microfluidic devices developed over the past two decades, including continuous-flow channels, microarray-embedded channels, droplet microfluidic channels, digital droplet channels, and gradient microfluidic channels. These devices are applied in biomedical diagnostics, enabling the simultaneous detection of multiple targets and improving sensitivity and reproducibility. The review highlights the advantages of SERS over conventional detection methods, such as higher sensitivity, better multiplex detection, and improved reproducibility. It also addresses challenges in SERS detection, such as the need for uniform nanoparticle aggregation and the limitations of small detection volumes. The review emphasizes the potential of SERS-based microfluidic technology for clinical diagnostics, including rapid and accurate detection of pathogens and biomarkers. The study concludes that further development is needed to translate these technologies into practical applications, including miniaturization of Raman spectrophotometers, improved flow control, and integration of machine learning for enhanced diagnostic accuracy. The review provides a comprehensive overview of the current state of SERS-based microfluidic devices and their potential for future clinical applications.