Flow boiling heat transfer in microchannels is used today in many diverse applications. The previous studies addressing the effect of channel size, heat flux, vapor quality, and mass flux on heat transfer during flow boiling are reviewed in the present paper. The relationship between flow characteristics and flow boiling heat transfer was studied experimentally for refrigerant R-C318 at moderate reduced pressures where the contribution of nucleate boiling is decisive. Flow boiling mechanisms were identified using an annular microchannel with transparent outer wall for successive visualization of boiling. The considerable suppression of nucleate boiling heat transfer was observed at transition to annular flow and explained by formation of a liquid flow with thin film and dry spots. A general equation for prediction of two-phase flow boiling heat transfer inside the circular, annular, and rectangular microchannels is proposed and verified using the experimental data. This equation accounts for the nucleate boiling suppression, forced convection, and thin film evaporative heat transfer in the form that allows to distinguish more clearly the contribution of each mechanism of heat transfer under the conditions, when it is predominant. A new approach for prediction of transition to the annular flow is proposed and verified, using the experimental data.