Organoids have become the preferred model for new drug development, pathological and toxicological research, and mechanistic exploration in recent years because of their ability to maximally simulate the structure and function of human tissues and organs in vitro. With the development of regenerative medicine technology and the gradual advancement of organoid research, organoids lacking a vascularized microenvironment suffer from apoptosis and even tissue necrosis in the later stage of culture because of the lack of oxygen and nutrients, making it difficult to maintain the structure and function of the organoid in the long term. This has become a major obstacle for further application in the clinic. By focusing on the above issues, this review summarizes the formation of blood vessels and the current construction system of vascularized organoids in vitro, and condenses the core problems in the culture of vascularized organoids to provide new perspectives for future research and applications.