Abstract: Continuous flow chemistry, a transformative technology enabling chemical reactions in continuous flow systems, has gained significant importance in pharmaceuticals, chemical engineering, energy, and materials science. The integration of enzymatic catalysis, particularly valued for its exceptional enantioselectivity, has demonstrated remarkable advantages for pharmaceutical synthesis in flow systems. However, achieving efficient and cost-effective regeneration of oxidoreductase cofactors NAD(P)⁺ remains a critical scientific challenge. This review comprehensively summarizes recent advances in cofactor recycling strategies within continuous flow biocatalytic systems, critically examines key limitations in current cofactor regeneration approaches, and proposes future research directions to accelerate the industrial applications of flow-based biocatalysis.