Photoacoustic (optoacoustic) tomography, combining optical absorption contrast and highly scalable spatial resolution (from micrometer optical resolution to millimeter acoustic resolution), has broken through the fundamental penetration limit of optical ballistic imaging modalities—including confocal microscopy, two-photon microscopy, and optical coherence tomography—and has achieved high spatial resolution at depths down to the diffusive regime. Optical absorption contrast is highly desirable for microvascular imaging and characterization because of the presence of endogenous strongly light-absorbing hemoglobin. We focus on the current state of microvascular imaging and characterization based on photoacoustics. We first review the three major embodiments of photoacoustic tomography: microscopy, computed tomography, and endoscopy. We then discuss the methods used to characterize important functional parameters, such as total hemoglobin concentration, hemoglobin oxygen saturation, and blood flow. Next, we highlight a few representative applications in microvascular-related physiological and pathophysiological research, including hemodynamic monitoring, chronic imaging, tumor-vascular interaction, and neurovascular coupling. Finally, several potential technical advances toward clinical applications are suggested, and a few technical challenges in contrast enhancement and fluence compensation are summarized.