The reduction of sugar intake by adults has been stated by the World Health Organization as an important strategy to reduce the risk of non-communicable diseases. Erythritol is a four-carbon sugar alcohol that is considered as a highly suitable substitution for sucrose. This review article covers approaches for the separate stages of the biotechnological production of erythritol from cultivation to the downstream section. The first part focuses on the cultivation stage and compares the yields of erythritol and arising by-products achieved with different types of substrates (commercial versus alternative ones). The reported numbers obtained with the most prominently used microorganisms in different cultivation methods (batch, fed-batch or continuous) are presented. The second part focuses on the downstream section and covers the applied technologies for cell removal, recovery, purification and concentration of erythritol crystals, namely centrifugation, membrane separation, ion and preparative chromatography, crystallization and drying. The final composition of the culture broth and the preparative chromatography separation performance were identified as critical points in the production of a high-purity erythritol fraction with a minimum amount of losses. During the review, the challenges for a biotechnological production of erythritol in a circular economy context are discussed, in particular regarding the usage of sustainable resources and minimizing waste streams.