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Abstract: The development of solid phase microextraction (SPME) has seen huge growth since its conception as a new approach to sample preparation in the early 1990s. In comparison to existing technologies such as liquid-liquid or solid phase extraction (LLE and SPE, respectively), the technique offers many advantages, including simplicity, speed, solventless extraction, and a convenient format. However, an important aspect in the future application and growth of SPME is the development of new extraction coatings. The objective of this review is to present an overview of the advances in coating development for solid phase microextraction (SPME). More specifically, this review will focus on the use of molecular recognition elements in SPME coatings to provide enhanced extraction selectivity and their applicability to the direct analysis of complex samples, such as biological fluids. The work will also include short overviews of emerging extraction phase technologies such as molecularly imprinted polymers (MIPs) and restricted access materials (RAM). The biocompatibility of RAMs has been combined with SPME and highlighted in several examples for more targeted and direct extraction possibilities in complex samples. The ability to perform direct and selective extraction of analytes from complex samples will extend SPME into the field of bioanalysis. Lastly, the future outlook for SPME and potential new applications for these fibers will be discussed