Genetic testing based on the analysis of circulating cell-free DNA (cfDNA) in body fluids, especially blood plasma, is raising interest for the management and follow-up of many diseases, including cancer. Because the concentration of cfDNA is low and its composition mostly degraded, this material can only be assayed with the most sensitive nucleic acid processing technologies. cfDNA analysis therefore constitutes a model target and a driving force for innovation in microfluidic biotechnologies. Here, we overview the main physico-chemical characteristics of cfDNA, and provide a critical review on the different methods for its processing out of blood samples. Then, we describe recent microfluidic developments for high sensitivity DNA analysis, evaluate their practical relevance for cfDNA analysis, and identify a few challenges for technologists in the near future.