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A review is carried out on the development of small- and micro-scale biomass-fuelled combined heat and power (CHP) systems. Discussions have been concentrated on the current application of Organic Rankine Cycle (ORC) in small- and micro-scale biomass-fuelled CHP systems. Comparisons have been made between ORC and other technologies such as biomass gasification and micro-turbine based biomass-fuelled CHP systems. The advantages and disadvantages of each technology have been discussed. Recommendations have been made on the future development of small- and micro-scale biomass-fuelled CHP.