One of the most critical issues in terms of environmental pollution is the contamination with heavy metals. Some metals are beneficial for the development of organisms in small amounts, but some are very toxic and can generate a high negative impact in the natural world. The metals that are most commonly detected in aquatic ecosystems and affect the water bodies are mercury, lead, cadmium and nickel. Microorganisms have a wide range of applications that they can be used for owing to their high adaptability, diverse chemical composition and possibilities of transformation through genetic modification. The capacity of microorganisms to remove heavy metals has been thoroughly explored in lab-scale research with optimization tests performed mostly using mono-metallic solutions. The obtained data shows very good capacity of microorganisms in the removal of single metal ions. However, real effluents are usually composed of more types of metals. Depending on the industry, the composition of the wastewater can be relatively complex. In order to upscale the application of microbial organisms used for heavy metals removal, a comprehensive research analyzing the main parameters and their influence is required as well. Some work has been carried out in this sense, but mostly again, at laboratory scale, using artificial solutions or in some cases also real effluents. The mechanisms involved in the uptake of multiple metal ions from aqueous solutions by microorganisms require further understanding. This current investigation aims to synthesize the available research data regarding the treatment of multimetallic solutions using microbial and to identify the main aspects that require attention in an expanded approach of scientific studies.