<p>This review critically synthesizes recent advances in rare-earth element (REE) doped bioactive glasses (BAGs), focusing specifically on how Lanthanum (La), Dysprosium (Dy), Terbium (Tb), Holmium (Ho), Gadolinium (Gd), and Yttrium (Y) alter glass structure and thereby mechanical performance and biomedical function. Unlike previous reviews that emphasize either bioactivity or optical/magnetic properties alone, our manuscript integrates atomic-scale structural evidence, processing-dependent effects (melt-quench vs sol–gel), and in-vitro/in-vivo outcomes to link dopant chemistry with osteogenesis, antimicrobial activity, imaging functionality and mechanical reliability. We also discuss practical challenges for scale-up, safety and clinical translation, and propose targeted future research directions. This integrated perspective aims to guide design decisions for next-generation BAG scaffolds and implant coatings where combined mechanical robustness and therapeutic functionality are required.</p> Graphical Abstract <p></p>