The ability to retain and process an object's identity and spatial location is essential for many daily tasks, often referred to as visual-spatial working memory. Research investigating visual-spatial processing has concentrated on three aspects or mechanisms thought to sub-serve this process; perceptual processes, anatomical correlates and working memory functions. An approach integrating all three areas has largely been neglected. Hence, this review sought to (1) outline some of the advances made to the understanding by these three concepts or models of visual-spatial processing, (2) establish the relationship between these processes, and discuss the challenges faced by researchers attempting to dissociate this functions from other visual-spatial processes as well as other working memory functions. It is suggested that a more comprehensive and integrative understanding of visual-spatial working memory has implications for research seeking to investigate visual-spatial memory, and to relate visual-spatial memory to other cognitive functions, such as executive function and attention.