Bacterial cellulose (BC), which can be produced by microorganisms, is an ideal biomaterial especially for tissue engineering and drug delivery systems thanks to its properties of high purity, biocompatibility, high mechanical strength, high crystallinity, 3 D nanofiber structure, porosity and high-water holding capacity. Therefore, wide ranges of researches have been done on the BC production process and its structural and physical modifications to make it more suitable for certain targeted biomedical applications thoroughly. BC’s properties such as mechanical strength, pore diameter and porosity can be tuned in situ or ex situ processes by using various polymer and compounds. Besides, different organic or inorganic compounds that support cell attachment, proliferation and differentiation or provide functions such as antimicrobial effectiveness can be gained to its structure for targeted application. These processes not only increase the usage options of BC but also provide success for mimicking the natural tissue microenvironment, especially in tissue engineering applications. In this review article, the studies on optimisation of BC production in the last decade and the BC modification and functionalisation studies conducted for the three main perspectives as tissue engineering, drug delivery and wound dressing with diverse approaches are summarized.