MXenes have demonstrated significant advantages in smart diagnostic systems, neural engineering interfaces and tissue regeneration engineering due to their abundant surface functional groups, large specific surface area, metal-like conductivity and excellent photothermal conversion efficiency. However, there are still many key challenges for the deep integration of multifunctional synthesis strategies and biomedical applications, such as the unclear long-term evolution of biocompatibility and immunoregulation mechanisms, and the immature conditions for clinical translation. This review systematically compiles advantages of MXenes, their synthetic pathways, and cutting-edge applications in biomedical engineering, providing researchers with comprehensive technical references. Furthermore, it reveals the translational potential of MXenes in precision tumour therapy, intervention of neurodegenerative diseases, and regenerative medicine, facilitating intelligent and integrated leapfrog development of biomedical engineering.