OBJECTIVES: Personalized medicine (PM) takes into account that diagnostic and therapeutic health technologies should be based on individual characteristics of patients such as risk profile and treatment response. Health policy decisions under constrained resources in PM require adequate evaluation methods that incorporate economic aspects and multiple characteristics (e.g., genotypes, blood markers). Microsimulation is a technique to evaluate health technologies, policies and interventions based on individual characteristics. Our goal was to identify and contrast different microsimulation approaches and discuss the applicability of these approaches in the evaluation of PM. METHODS: We performed a review on microsimulation and applications in social sciences, health care and politics. Assessment criteria include the modeling of patient characteristics/patient history/prior events, the way events or transitions between health states are modeled, the inclusion of life years/utilities/costs, open/closed cohort approach, and the way time is modeled. RESULTS: Identified approaches range from state-transition models, discrete-event-simulation models to equation-based models. Individual characteristics relevant for PM include individual risk factors, clinical properties, patient history, severity of disease, number of repeated events. Different approaches were used to link risk factors and predictors to prognosis and treatment decisions and success as well as resource use. E.g., POHEM is a  leading Canadian microsimulation  for health care policies. Applications range from lung cancer treatment, breast cancer prevention to the evaluation of cardiovascular diseases. To support decisions on HIV prevention Rauner et. al. built a discrete-event-simulation where breast feeding mothers are even linked to their children. Overall microsimulation has been successfully applied e.g., in cancer research, chronic diseases or screening and prevention. CONCLUSIONS: Microsimulation techniques are broadly applied but still underrepresented in economic evaluations for health care policies. Microsimulation is a powerful tool for evaluating PM-strategies, because it can be used to incorporate the genetic and clinical heterogeneity of individuals as well as personalized decision algorithms.