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GaN-based micro-size light-emitting diodes (µLEDs) have a variety of attractive and distinctive advantages for display, visible-light communication (VLC), and other novel applications. The smaller size of LEDs affords them the benefits of enhanced current expansion, fewer self-heating effects, and higher current density bearing capacity. Low external quantum efficiency (EQE) resulting from non-radiative recombination and quantum confined stark effect (QCSE) is a serious barrier for application of µLEDs. In this work, the reasons for the poor EQE of µLEDs are reviewed, as are the optimization techniques for improving the EQE of µLEDs.