Microalgae cultivation, when compared to the growth of higher plants, presents many advantages such as faster growth, higher biomass productivity, and smaller land area requirement for cultivation. For this reason, microalgae are an alternative platform for carotenoid production when compared to the traditional sources. Currently, commercial microalgae production is not well developed but, fortunately, there are several studies aiming to make the large-scale production feasible by, for example, employing different cultivation systems. This review focuses on the main carotenoids from microalgae, comparing them to the traditional sources, as well as a critical analysis about different microalgae cultivation regimes that are currently available and applicable for carotenoid accumulation. Throughout this review paper, we present relevant information about the main commercial microalgae carotenoid producers; the comparison between carotenoid content from food, vegetables, fruits, and microalgae; and the great importance and impact of these molecule applications, such as in food (nutraceuticals and functional foods), cosmetics and pharmaceutical industries, feed (colorants and additives), and healthcare area. Lastly, the different operating systems applied to these photosynthetic cultivations are critically discussed, and conclusions and perspectives are made concerning the best operating system for acquiring high cell densities and, consequently, high carotenoid accumulation.