Despite the lower efficiency for thermoelectric cooling technology compared to conventional mechanical cooling technology, it finds application in commercial portable cooling due to its compactness, simple device design, and low noise. The rapid progress in flexible and wearable electronics opens the need for flexible cooling technology for local thermal regulation where thermoelectric cooling technology offers niche advantages suitable for flexible cooling such as light weight and no moving parts. Organic thermoelectrics hold promise for flexible and wearable cooling applications due to their intrinsic mechanical flexibility, low thermal conductivity, and ease of processing. However, research on organic Peltier cooling devices remains limited, and more work is required to exploit their potential for flexible cooling applications. This review discussed the state-of-the-art organic Peltier cooling devices and the materials and device design considerations required for advancing organic Peltier device technology toward practical applications.