Sediment microbial fuel cells (SMFCs) are different from microbial fuel cells because they are completely anoxic and lack a membrane. SMFCs are a novel technology for the simultaneous production of renewable energy and bioremediation of heavy metals. Recently, SMFCs have attracted the attention of many researchers because of their moderate functioning parameters and ability to use a range of biodegradable substrates like glucose, glutamic acid, river water, cysteine, acetate, and starch. The inocula used in SMFCs include river sediment, marine sediment, and wastewater. For power generation, many exoelectrogens in SMFCs have the ability to transfer electrons from electrodes by using natural electron shuttles. Exoelectrogens use four primary pathways to transfer electrons to the electrodes, including short-range electron transfer through redox-active proteins, soluble electron shuttling molecules, long-range electron transport by conductive pili, and direct interspecies electron transfer. The most dominant mechanism is long-range electron transfer via conductive pili because pili have metal-like conductivity. The powering by microbes is an emerging technique for the remediation of heavy metals from sediments. The pathways for transferring electrons in electrotrophs operate in the opposite direction from those in exoelectrogens. To further upgrade SMFC technology, this review targets the prototype, operating factors, working mechanisms, applications, and future perspectives of SMFCs. Copyright (c) 2017 John Wiley & Sons, Ltd.