Moving bed biofilm reactor (MBBR) technology has emerged as a highly efficient and robust process for biological wastewater treatment, offering advantages such as compact reactor footprint, enhanced biomass retention, and resistance to loading fluctuations. This review provides a comprehensive overview of the application of MBBR technology in laboratory-scale reactors, highlighting its underlying principles and comparing it to traditional suspended and attached growth systems. Emphasis is placed on design considerations, operational parameters, and performance evaluation in terms of pollutant removal efficiency and process stability. Moreover, the paper discusses the latest advancements and future perspectives concerning new carrier media materials, hybrid reactor configurations, and potential for full-scale implementation. The findings underscore the adaptability and effectiveness of MBBR technology in achieving superior treatment performance, making it an attractive option for researchers and practitioners seeking to address a wide array of wastewater challenges.