<p>Extensive theoretical and empirical studies have demonstrated that photocatalytic technologies provide promising eco-friendly and sustainable solutions for combating persistent infections caused by multidrug-resistant bacteria, overcoming the limitations of traditional antibiotic therapies. However, there is still a lack of comprehensive and in-depth insights on how to rationally and systematically design high-performance photocatalysts to achieve stable and satisfactory antibacterial functions. Particularly, existing literatures lack a holistic overview of the functional characteristics, intrinsic photoresponse behavior, and underlying antibacterial mechanisms of various typical photocatalytic materials. Meanwhile, a systematic collation of modification strategies for enhancing light absorption, carrier separation and catalytic activity is still insufficient. Thus, this review systematically investigates the functionalization design and fundamental operational principles of representative antibacterial photocatalysts, elucidating the ROS-mediated reaction pathways and intrinsic mechanisms through which different catalytic systems achieve potent antibacterial effects. It further evaluates how microstructure regulation and electronic band structure variations influence carrier migration and catalytic performance, offering a detailed comparative analysis of their practical disinfection efficacy. Additionally, the paper critically summarizes the current technical bottlenecks, application limitations and future optimization directions in photocatalytic antibacterial technology, aiming to deepen the fundamental understanding of catalytic systems and accelerate the development of advanced functional photocatalytic materials to meet escalating demands for environmental remediation and sustainable public healthcare solutions.</p>