Microfluidics and 3D printing will allow a faster research and development in pharmaceutical and medical areas, supporting new solutions for active pharmaceutical production and clinical tests without the necessity of in vivo animal models. The present review aims to show the role of these two technologies in the resolution of current pharmaceutical issues (e.g., efficient continuous production of active pharmaceutical ingredients, high costs for medicine development and lack of preclinical systems capable to predict accurate human responses to new medicine drugs) and in the development of biomedical and tissue engineering. The present paper was divided into the following sections: microfluidics and active pharmaceutical ingredients synthesis, organs-on-a-chip and multiorgans microdevices, 3D printing/bioprinting, and hydrogels and bioinks. Finally, conclusions and future perspectives are exposed.