Selenium nanoparticles (SeNPs) are extremely popular objects in nanotechnology. “Green” synthesis has special advantages due to the growing necessity for environmentally friendly, non-toxic, and low-cost methods. This review considers the biosynthesis mechanism of bacteria, fungi, algae, and plants, including the role of various biological substances in the processes of reducing selenium compounds to SeNPs and their further packaging. Modern information and approaches to the possible biomedical use of selenium nanoparticles are presented: antimicrobial, antiviral, anticancer, antioxidant, anti-inflammatory, and other properties, as well as the mechanisms of these processes, that have important potential therapeutic value.