Optical manipulation in a static environment promises numerous biological applications. This mostly deployed environment endows an idea testbed with various advantages, such as stability, highly controllable, reduced motion artifacts, high precision, easy configuration, integration, etc. However, some intrinsic deficiencies must be noticed, such as low throughput, lack of dynamic control, heat accumulation, etc. A fluidic environment provides alternative strategies for biomedical studies by leveraging its merits of high throughput, multi-phase control, efficient interaction, etc. In this chapter, we center our attention on advances in biomedical applications using optical tweezers in optofluidic environments. We begin by elaborating on some fundamental physics of forces in optofluidics systems, describing how those forces interplay and play important roles in optical manipulation. We then outline some typical examples of optical manipulation in optofluidics, including bioparticle transporting, sorting, detection, interaction, measurement, etc. This chapter concludes with our vision of the perspectives of ongoing research directions and how this field can evolve to facilitate more prosperous applications in the future.