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Fundamental research into how microbes generate electricity within microbial fuel cells (MFCs) has far outweighed the practical application and large scale development of microbial energy harvesting devices. MFCs are considered alternatives to standard commercial polymer electrolyte membrane (PEM) fuel cell technology because the fuel supply does not need to be purified, ambient operating temperatures are maintained with biologically compatible materials, and the biological catalyst is self-regenerating. The generation of electricity during wastewater treatment using MFCs may profoundly affect the approach to anaerobic treatment technologies used in wastewater treatment as a result of developing this energy harvesting technology. However, the materials and engineering designs for MFCs were identical to commercial fuel cells until 2003. Compared to commercial fuel cells, MFCs will remain underdeveloped as long as low power densities are generated from the best systems. The variety of designs for MFCs has expanded rapidly in the last five years in the literature, but the patent protection has lagged behind. This review will cover recent and important patents relating to MFC designs and progress.