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Advances in nanotechnology have led to the development of antimicrobial technology of nanomaterials. In recent years, photocatalytic antibacterial disinfection methods with ZnO-based nanomaterials have attracted extensive attention in the scientific community. In addition, recently widely and speedily spread viral microorganisms, such as COVID-19 and monkeypox virus, have aroused global concerns. Traditional methods of water purification and disinfection are inhibited due to the increased resistance of bacteria and viruses. Exploring new and effective antimicrobial materials and methods has important practical application value. This review is a comprehensive overview of recent progress in the following: (i) preparation methods of ZnO-based nanomaterials and comparison between methods; (ii) types of nanomaterials for photocatalytic antibacterials in water treatment; (iii) methods for studying the antimicrobial activities and (iv) mechanisms of ZnO-based antibacterials. Subsequently, the use of different doping strategies to enhance the photocatalytic antibacterial properties of ZnO-based nanomaterials is also emphatically discussed. Finally, future research and practical applications of ZnO-based nanomaterials for antibacterial activity are proposed.