The ever-increasing requirement for pathogenic-resistant atmospheres and sanitation has propelled the progress of antimicrobial coatings across all areas and has not been limited to healthcare facilities. These antibacterial paints and coatings have now become a crucial revolution in surface protection technologies. The chapter explores all the possible roles of surface engineering in enhancing the functionality and efficiency of antimicrobial paint, along with taking care of the sustainability criteria. It delves foremost into the fundamental mechanism of antimicrobial action, along with types of antimicrobial agents used to incorporate the antimicrobial properties. A comprehensive discussion follows up those deals with different surface engineering techniques for antimicrobial coatings, such as chemical method, physical method, bio-inspired and nanomaterial-assisted strategies that contribute towards improving pathogenic resistance, durability and environmental compatibility. Key applications of these coatings and paints in healthcare environments, food storage areas, marine industries, commercial and residential areas are highlighted, alongside a discussion on testing standards and protocols for performance assessment. The chapter is focused on the most recent developments on coatings, where case studies and empirical examples and the psychological aspect of functions are illustrated to put the functional efficacy of antimicrobial paints into perspective. A comparison of performance metrics of surface-engineered coatings with conventional paints is also addressed. Finally, it also provides insights into the future emerging materials and technologies in antimicrobial coatings.