Bioelectrochemical systems (BESs) are devices capable of converting chemical energy into electrical energy using microorganisms as catalysts. These systems have been extensively studied at the laboratory level, but, due to multiple difficulties, their large-scale implementation has been explored only sparingly. This study presents the most recent technological advances for scaling up BESs. In the same way, the main technical and economic challenges that hinder the correct implementation of these systems at a large scale are mentioned. The study concludes with a review of successful case studies in scaling up BESs and discusses future directions and emerging trends.