Polymers are the backbone of pharmaceutical drug delivery. There are several polymers with varying properties available today for use in different pharmaceutical applications. Alginate is widely used in biomedical research due to its attractive features such as biocompatibility, biodegradability, inertness, low cost, and ease of production and formulation. Encapsulation of therapeutic agents in alginate/alginate complex microspheres protects them from environmental stresses, including the acidic environment in the gastro-intestinal tract (GIT) and enzymatic degradation, and allows targeted and sustained delivery of the agents. Microencapsulation is playing an increasingly important role in drug delivery as evidenced by the recent surge in research articles on the use of alginate in the delivery of small molecules, cells, bacteria, proteins, vaccines, and for tissue engineering applications. Formulation of these alginate microspheres (AMS) are commonly achieved by conventional external gelation method using various instrumental manipulation such as vortexing, homogenization, ultrasonication or spray drying, and each method affects the overall particle characteristics. In this review, an inclusive summary of the currently available methods for the formulation of AMS, its recent use in the encapsulation and delivery of therapeutics, and future outlook will be discussed.