The field of acousto-optical tomography (AOT) for medical applications began in the 1990s and has since developed multiple techniques for the detection of ultrasound-modulated light. Light becomes frequency shifted as it travels through an ultrasound beam. This “tagged” light can be detected and used for focused optical imaging. Here, we present a comprehensive overview of the techniques that have developed since around 2011 in the field of biomedical AOT. This includes how AOT has advanced by taken advantage of the research conducted in the ultrasound, as well as, the optical fields. Also, simulations and reconstruction algorithms have been formulated specifically for AOT imaging over this time period. Future progression of AOT relies on its ability to provide significant contributions to in vivo imaging for biomedical applications. We outline the challenges that AOT still faces to make in vivo imaging possible and what has been accomplished thus far, as well as possible future directions.