Abstract: Hydrogel microspheres combine the characteristics of hydrogels and microspheres, featuring a porous structure, responsive release, and excellent biocompatibility. They have received extensive attention in the field of antibacterial in recent years. In contrast to conventional antimicrobial methods, hydrogel antimicrobial can achieve sustained release, targeted release, and multi-functional synergistic antibacterial effects. Therefore, microspheres show significant advantages in bone tissue regeneration, wound repair and targeted drug delivery. For example, in vivo degradability, controlled release, and responsiveness. This review comprehensively summarizes the constituent materials, preparation methods, and latest application research progress of the hydrogel antibacterial microspheres, aiming to provide insights and references for their further development and application in the biomedical field.