The sensitive detection of chiral compounds by capillary electrophoresis (CE) in biological samples remains a significant challenge and is currently considered a bottleneck in many chiral analysis projects. Chiral CE-MS can significantly improve the limit of detection and provide high sensitivity compared with chiral CE-UV. Chiral selectors such as modified cyclodextrins (CDs) and polymeric surfactants (a.k.a. molecular micelles, MoMs) in electrokinetic chromatography (EKC), micellar electrokinetic chromatography (MEKC) and capillary electrochromatography (CEC) have been developed to address the need for high sensitivity by CE-MS. However, several problems remain to be investigated to fully understand the potential of these hyphenation modes. This review provides introduction to major chiral CE-MS modes for the novice and highlights the important working principles of each mode of chiral CE-MS. Next, recent practical developments and progress in chiral CE-MS dating from January 2010 to September 2015 are described. The achievements in clinical and biomedical sciences using a variety of chiral selectors such as CDs and MoMs in EKC-MS, MEKC-MS and CEC-MS are discussed. Finally, conclusions and future prospects of CE-MS in chiral analysis are drafted.