The combined negative effect of both fresh water shortage and energy depletion has encouraged the research to move forward to explore effective solutions for water desalination with less energy consumption. Reverse osmosis (RO), the most common technology for desalination today, uses much less energy than thermal processes. Several modifications and improvements have been made to RO during the last four decades in order to minimize energy consumption, and the process is now near thermodynamic limits. To further reduce energy requirements for desalination, other approaches are needed. A microbial desalination cell (MDC) is a recent technology that could be used as an alternative to RO. An MDC uses electrical current, produced by electrochemically active bacteria, to concurrently generate bioenergy, treat wastewater, and desalinate water. In an attempt to answer the question of whether this emerging technology has the ability to stand alone as an efficient replacement for RO, or it is best if used as an RO pre-treatment setup, this review addresses the near-future application of MDCs in terms of its integration with RO operation.