The design and engineering of advanced polymeric antimicrobial food packaging systems have gained significant attention due to the growing consumer demand for minimally processed, fresh-like foods without added chemical preservatives. These products are highly susceptible to microbial contamination and spoilage, leading to increased food waste. In response, the development of antimicrobial packaging capable of releasing agents to protect food during storage and transport, while extending shelf life, has emerged as a promising solution. This need has sparked extensive research in food packaging, resulting in various antimicrobial systems. This chapter provides a comprehensive overview of these systems, including antimicrobial-emitting sachets and absorbent pads, antimicrobial-coated films, antimicrobial polymers, edible coatings, and engineered antimicrobial surfaces using plasma technology. Each system’s advantages, limitations, and overall effectiveness will be thoroughly examined.