PurposeZinc oxide nanoparticles (ZnO NPs) are among the most important nanomaterials employed in biomedical applications. Biopolymers have been extensively utilized in biomedicine owing to their numerous advantages. In the field of medicine, ZnO NPs coated with biopolymers have demonstrated tremendous potential. Through the activation of apoptotic signaling pathways and the reduction of intracellular reactive oxygen species (ROS) generation, they effectively inhibit cancerous cells and microbes. This makes ZnO NPs surface coated with biopolymers a promising candidate for applications in biomedicine. Thus, this review aims to evaluate the primary biomedical importance of ZnO NPs and ZnO NPs surface coated with biopolymers for drug delivery and biomedical applications.MethodsSynthesis approaches, comprising chemical and biological approaches, are explored. The chemical approach focuses on techniques such as sol-gel, hydrothermal, and solvothermal while biological methods utilize natural sources like plants and microbes. The synthesized ZnO NPs were analyzed utilizing several characterization techniques.ResultsThe modification improves the compatibility of ZnO NPs by employing biopolymer as a capping agent, potentially improving their effectiveness in drug delivery and biological applications. However, ZnO NPs and ZnO NPs surface coated with biopolymers have a wide range of biomedicine uses, in drug transport, bioimaging, and therapeutic actions against cancer, microbial infections, and diabetes. Furthermore, improvements to ZnO NPs for drug administration often include efforts to increase biocompatibility, targeted drug delivery, and cellular absorption while limiting potential adverse consequences. These modifications can assist in stabilizing nanoparticles and allow the attachment of certain proteins for targeted distribution and therapeutic activity against diabetes and microbial infections.ConclusionThis study reveals that ZnO NPs and ZnO NPs fabricated with biopolymers such as chitosan, alginate, collagen, polysaccharides, and starch have tremendous potential in biomedical applications, granting precise drug delivery, antimicrobial properties, anti-diabetic therapies, and bioimaging capabilities. ZnO NPs, particularly when modified with biopolymers, are anticipated to play a crucial role in driving new discoveries in the biomedical field.Lay SummaryA systematic literature analysis was undertaken to assess the biomedical importance of ZnO NPs and surface-modified ZnO NPs capped with biopolymers for biomedical applications. The review comprised 190 articles out of 1190 retrieved. Chemical and biogenic approaches have been observed to be effective in producing high-quality ZnO NPs. ZnO NPs, however, have numerous applications in the biological field. The therapeutic potential of ZnO NPs is increased when they are surface coated with biopolymers, particularly for drug delivery and other biological applications like antimicrobial qualities, anti-diabetic drugs, and bioimaging capabilities. Biopolymer-modified ZnO NP surfaces could contribute to major breakthroughs in biomedical science.