Biocompatible hydrotalcite nanohybrids, i.e., layered double hydroxide (LDH) based nanohybrids have attracted significant attention for biomedical functions. Benefiting from good biocompatibility, tailored drug incorporation, high drug loading capacity, targeted cellular delivery and natural pH-responsive biodegradability, hydrotalcite nanohybrids have shown great potential in drug/gene delivery, cancer therapy and bio-imaging. This review aims to summarize recent progress of hydrotalcite nanohybrids, including the history of the hydrotalcite-like compounds for application in the medical field, synthesis, functionalization, physicochemical properties, cytotoxicity, cellular uptake mechanism, as well as their related applications in biomedicine. The potential and challenges will also be discussed for further development of LDHs both as drug delivery carriers and diagnostic agents.