The Mizoroki-Heck reaction is one of the most studied palladium-catalyzed cross-coupling reactions, representing a powerful method for forming C-C bonds between diverse substrates with broad functional group compatibility. However, the reductive variant has received considerably less attention. In this Review, we summarize distinct mechanistic aspects of the reductive Heck reaction, highlight recent contributions to the field, and discuss potential applications of the reductive Heck reaction in the pharmaceutical industry. With the potential to have a large impact in both academic and industrial settings, further development of the reductive Heck reaction is a promising area of future investigation.