Chitosan, a biopolymer produced from chitin, is gaining a lot of interest in biomedical research due to its intrinsic biocompatibility, biodegradability, and antimicrobial properties, making it suitable for wound dressing applications. This chapter provides a comprehensive overview of chitosan-based systems for wound treatment solutions. It begins with an analysis of chitosan’s chemical composition and physicochemical properties, which support its biological functionality. The antimicrobial mechanism of chitosan is thoroughly investigated, including its capacity to disrupt microbial membranes, interact with DNA, and influence fungal cells. Chitosan’s interaction with mammalian cells involved in wound healing is also examined, with a focus on its immunomodulatory and regenerative potential. The molecular weight, degree of deacetylation, pH, and origin of chitosan are examined as key parameters determining its antimicrobial activity. The wound healing process is divided into three main stages: inflammation, proliferation, and remodeling. Finally, this chapter presents recent advances in wound dressings formulated with chitosan in conjunction with natural or synthetic polymers and bioactive agents. These composite materials have improved antimicrobial, structural, and regenerative properties, making them potentially useful for the treatment of acute and chronic wounds.