Centrifugal pumps are one of the significant consumers of electricity and are one of the most commonly encountered rotodynamic machines in domestic and industrial applications. Centrifugal pumps operating at off-design conditions are often subject to different periodic flow randomness, which in turn hampers functionality and performance of the pump. These limitations can be overcome by modification in the conventional design of different components of a centrifugal pump, which can assuage flow randomness and instabilities, reconstitute flow pattern and minimize hydraulic flow losses. In this article, flow vulnerabilities like pressure and flow inconsistency, recirculation, boundary layer separation, adverse rotor-stator interaction, and the effects on operation and performance of a centrifugal pump are reviewed. This article also aims to review design modification attempts made by different researchers such as impeller trimming, rounding, geometry modification of different components, providing microgrooves on the impeller and others. Based on the findings of this study, it is concluded that some design modifications of the impeller, diffuser, and casing result in improvement of functionality, efficiency, and reduction in pressure fluctuations, flow recirculation, and vibrations. Design modifications should improve the performance without hampering functionality and useful operational range of the pump. Considerable research is still necessary to continue understanding and correlating flow physics and design modifications for the pump impeller, diffuser, and casing. © 2019 by ASME.