Refractory organic wastewater mainly includes wastewater from papermaking, textile, printing and dyeing, petrochemical, coking, pharmaceutical and other industries, as well as landfill leachate and its membrane-treated concentrate. The traditional biochemical method is difficult to adapt to its harsh conditions such as high toxicity, high organic load and high salinity. Compared to other methods, the electro-oxidation (EO) process owns the attractive characteristics of being clean and eco-friendly, highly efficient and producing no secondary pollution. EO systems mainly include electrodes, a reactor, a power supply and other basic units. The design of reactors with different electrodes was the key link in the application of EO technology. This paper mainly reported the different configurations of electrochemical reactors (ECRs) for refractory organic wastewater treatment, and summarized the advantages and disadvantages of them, including reactor structure, flow mode, operation mode and electrode construction. Compared with traditional reactors, the improved reactors such as 3D-ECR achieve higher mass transfer efficiency by increasing the contact area between the electrode and the fluid. Additionally, it has a higher removal rate of organics and a lower energy consumption. Finally, the future perspectives of the treatment of refractory organic wastewater by ECRs is discussed. This paper is expected to provide a reliable scientific basis for the real application of EO technology in refractory organic wastewater treatment.