Research efforts on flow boiling in microchannels were focused on stabilizing the flow during the early part of the last decade. After achieving that goal through inlet restrictors and distributed nucleation sites, the focus has now shifted on improving its performance for high heat flux dissipation. The recent worldwide efforts described in this paper are aimed at increasing the critical heat flux (CHF) and reducing the pressure drop, with an implicit goal of dissipating 1 kW/cm2 for meeting the high-end target in electronics cooling application. The underlying mechanisms in these studies are identified and critically evaluated for their potential in meeting the high heat flux dissipation goals. Future need to simultaneously increase the CHF and the heat transfer coefficient (HTC) has been identified and hierarchical integration of nanoscale and microscale technologies is deemed necessary for developing integrated pathways toward meeting this objective.