During the past few years, extensive research has been conducted on textiles with antimicrobial properties, owing to their indispensable role in diverse applications such as healthcare, medicine, athletic wear, personal protective equipment (PPE), footwear, and medical dressings. A wide range of antimicrobial agents has been utilized for fabricating these textiles, including natural and naturally derived compounds, organic and synthetic reagents (e.g., triclosan, quaternary ammonium compounds [QACs], and nitrogen-halamines), as well as metals and metal oxide nanoparticles. The efficacy and applicability of these agents have been rigorously evaluated across various contexts. Modern processing techniques, such as surface coating, chemical bonding, nanotechnology, and microencapsulation, are employed to integrate these agents into textiles during manufacturing. While synthetic antimicrobial agents demonstrate strong pathogen-neutralizing capabilities and robust adherence to textile substrates, their use raises potential environmental, health, and safety concerns. These challenges have spurred the advancement of next-generation antimicrobial coatings, such as plant extract-derived silver and zinc nanoparticles, chitosan-based formulations, and biopolymer-integrated systems, which leverage green synthesis methodologies. These innovations aim to minimize environmental impact while preserving antimicrobial performance and improving the durability of treated textiles.