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Traditional residential heating systems have become very efficient, leaving little room for significant improvement. However, an alternative means of domestic heating was proposed that utilizes small scale power generation and space/hot water heating technologies known as micro-combined heat and power (mCHP) systems. These systems offer significant advantages to conventional heating systems including decreased energy usage, cost, and reduced CO2 emissions. In addition, because these mCHP systems operate as distributed generation, they also reduce transmission losses and eliminate peak demand issues. These benefits come at the expense of complexities including matching the heat to power ratio for the residential sector and significant daily cycling, among other challenges. Recently, fuel cell based mCHP systems have been proposed as a means of providing both heat and power for the residential sector. These systems are meant for power generation at high efficiency and low emissions, and the heat can still be recovered for space or hot water heating. These systems are still under development and significant research is being conducted to determine if fuel cell based systems can match the load requirements of a typical household. Despite the work performed, different studies have had drastically different conclusions for the fate of fuel cell systems leaving many unanswered questions for the future. A systematic review of current literature was undertaken to assess fuel cell based mCHP for the residential sector. The review highlighted many of the technical challenges facing these systems while also uncovering significant benefits and opportunities. In this paper, the results of the review are presented and an analysis of current trends and future priorities is assessed.