A defect detection and removal apparatus including a removing unit, an image capturing unit, and a determining unit is provided. The removing unit is configured to remove at least one defective micro-element on a substrate. The image capturing unit is configured to capture a detection image of at least one defective micro-element correspondingly on the substrate. The determining unit is coupled to the image capturing unit and the removing unit. The image capturing unit executes capturing a first detection image before the removing unit executes removing a defective micro-element, and executes capturing a second detection image after the removing unit executes removing the defective micro-element. The determining unit confirms whether the defective micro-element has been removed according to the first and second detection image obtained from the image capturing unit. A defect detection and removal method is also provided.