Continuous processing can be applied to the production of pharmaceutical intermediates and active pharmaceutical ingredients. Relatively small, well-designed continuous reactors offer enhanced heat and mass transfer rates, shorter inventories of hazardous materials and precise control of reaction and quench times compared with batch processing. These factors have a significant impact on the safety, quality and economics of a process. Continuous processing, a mainstay of the chemical industry, remains a novelty within the pharmaceutical industry; however, there has been renewed interest in the application of continuous processing to organic synthesis in the pharmaceutical industry in recent years, and this review discusses the opportunities for reaction engineering of low-molecular-weight compounds.