Green synthesis and nanomaterials have been the current trends in biomedical materials. In this study, Piper chaudocanum L. leaf extract-doped ZnO nanoparticles (PLE-doped ZnO NPs), a novel nanomaterial, were studied including the synthesis process, and the biomedical activity was evaluated. PLE-doped ZnO NPs were synthesized by the co-precipitation method, with differences in the synthesis procedures and dosages of the extract. The X-ray diffraction, Fourier transform infrared, scanning electron microscopy, energy dispersive X-ray spectroscopy, Brunauer–Emmett–Teller, ultraviolet-visible diffuse reflectance spectroscopy, and photoluminescence spectrum analysis results showed that the biosynthesized PLE-doped ZnO NPs were pure and in a hexagonal wurtzite phase. The PLE-doped NPs were synthesized by adding the extract to the zinc acetate solution before adjusting the pH and exhibited the smallest size (ZPS50 was 22 nm), the richest in the surface organic functional groups and the best optical activity. The highest antibacterial activity against P. aeruginosa and S. aureus was observed at 100 µg/mL of ZPS50 NPs, and the inhibition zone reached 42 and 39 nm, respectively. Moreover, ZPS50 NPs showed a moderate effectiveness against KB cancer cells with an IC50 value of 43.53 ± 2.98 µg/mL. This present study’s results suggested that ZPS50 NPs could be a promising nanomaterial in developing drugs for treating human epithelial carcinoma cells and infectious illnesses.