Recent years have witnessed the emergence of innovative analytical methods with high sensitivity and spatiotemporal resolution that allowed qualitative and quantitative analysis to be carried out at single-cell and subcellular levels. Electrochemiluminescence (ECL) is a unique chemiluminescence of high-energy electron transfer triggered by electrical excitation. The ingenious combination of electrochemistry and chemiluminescence results in the distinct advantages of high sensitivity, a wide dynamic range and good reproducibility. Specifically, single-cell ECL (SCECL) analysis with excellent spatiotemporal resolution has emerged as a promising toolbox in bioanalysis for revealing individual cells' heterogeneity and stochastic processes. This review focuses on advances in SCECL analysis and bioimaging. The history and recent advances in ECL probes and strategies for system design are briefly reviewed. Subsequently, the latest advances in representative SCECL analysis techniques for bioassays, bioimaging and therapeutics are also highlighted. Then, the current challenges and future perspectives are discussed.