Besides biomass production, some microalgae have been used to treat wastewater contamination. However, in general, high concentrations of heavy metals significantly inhibit algal growth. We thus need to find ways to promote the resistance of microalgae to heavy metals, increase their growth rate under stress, and achieve coupling of heavy metal removal and biomass production simultaneously. In this review, mechanisms for removal of heavy metals by microalgae are proposed. Effects of exogenous chemical additives (dissolved organic matters, formaldehyde, sulphate, phosphate, nitric oxide donors, etc.) on algal biosorption to heavy metals are summarized. Genetic manipulation and microalgal strain selection strategies are also introduced, especially for the acid-tolerant strains with high biosorption efficiencies to Cr(VI) and Cd²⁺ at low pH conditions. Recent advances in (semi)continuous heavy-metal-bioremediation and biomass-production coupled system with immobilized microalgae, as well as challenges and solutions to the commercialization and industrialization of the coupled system were discussed.