Microscale manipulation has advanced substantially in controlled locomotion and targeted transport, yet many biomedical applications require precise and adaptive interaction with biological micro-objects. At these scales, manipulation is realized through three main classes of platforms: embodied microrobots that physically interact as mobile agents, field-mediated systems that generate contactless trapping or manipulation forces, and externally actuated end-effectors that interact through remotely driven physical tools. Unlike macroscale manipulators, these systems function in fluidic, confined, and surface-dominated environments characterized by negligible inertia, dominant interfacial forces, and soft, heterogeneous, and fragile targets. Consequently, classical assumptions of dexterous manipulation, including rigid-body contact, stable grasping, and rich proprioceptive feedback, become difficult to maintain. This review introduces micro-dexterity as a framework for analyzing biological micromanipulation through the coupled roles of embodiment, perception, and control. We examine how classical manipulation primitives, including pushing, reorientation, grasping, and cooperative manipulation, are reformulated at the microscale; compare the architectures that enable them, from contact-based micromanipulators to contactless field-mediated systems and cooperative multi-agent platforms; and review the perception and control strategies required for task execution. We identify the current dexterity gap between laboratory demonstrations and clinically relevant biological manipulation, and outline key challenges for future translation.

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