This review paper serves as a critical study on various techniques used to cool photovoltaic thermal (PV/T) systems and to improve their efficiency. The growing concern about generating clean energy has led people to develop PV/T systems, which can produce electricity and thermal energy simultaneously. The paper discusses the latest cooling arrangements employed in PV/T systems, including air cooling, water cooling, bi-fluid cooling, heat pipe cooling, and phase change material-assisted cooling. The study also discusses thermal, electrical, and exergy analyses, as well as maintenance optimization methods reported in previous publications, to better understand the benefits and constraints of various PV/T technologies. Additionally, a brief introduction to recent trends, such as artificial intelligence (AI)-based optimization of PV/T cooling systems, is provided. Several research gaps have been identified, including the long-term stability of nanofluids, the optimization of hybrid cooling technology, thermal management, exergy performance, maintenance, and AI-assisted aspects of the technology. Instead of presenting an innovative cooling technique, the current study aims to conduct an extensive literature review and comparative analysis on PV/T cooling technology.