Laser speckle is a complex interference phenomenon that can easily be understood, in concept, but is difficult to predict mathematically, because it is a stochastic process. The use of laser speckle to produce images, which can carry many types of information, is called laser speckle imaging (LSI). The biomedical applications of LSI started in 1981 and, since then, many scientists have improved the laser speckle theory and developed different imaging techniques. During this process, some inconsistencies have been propagated up to now. These inconsistencies should be clarified in order to avoid errors in future works. This review presents a review of the laser speckle theory used in biomedical applications. Moreover, we also make a review of the practical concepts that are useful in the construction of laser speckle imagers. This study is not only an exposition of the concepts that can be found in the literature but also a critical analysis of the investigations presented so far. Concepts like scatterers velocity distribution, effect of static scatterers, optimal speckle size, light penetration angle, and contrast computation algorithms are discussed in detail.