A fascinating problem in the fields of nanoscience and nanobiotechnology has recently emerged, and to tackle this, the production of metal oxide nanoparticles using plant extracts offers numerous benefits over traditional physicochemical methods. In the present investigation, ZnO nanoparticles were fabricated from Bauhinia racemosa Lam. (BR) leaves extract with various transition metal (TM) dopants (Ni, Mn, and Co). Plant leaves extract containing metal nitrate solutions were utilized as a precursor to synthesize the pristine and TM-doped ZnO nanoparticles. Structural, functional, optical, and surface properties of the fabricated samples were studied by using physicochemical and photoelectrochemical measurements. The organic pollutants tetracycline (TC), ampicillin (AMP), and amoxicillin (AMX) were used in the photocatalytic degradation assessment of the fabricated samples. Through X-ray diffraction (XRD) and transmission electron microscopy (TEM) investigation, the fabricated nanoparticles wurtzite crystal structure was verified. Moreover, Fourier transform infrared (FT-IR) analysis verified the existence of functional groups in the fabricated nanoparticles. The migration of electrons from the deep donor level and zinc interstitial to the Zn-defect and O-defect is related to the emission peaks seen at 468, 480, 534, and 450 nm in photoluminescence (PL) spectra. Co-ZnO nanoparticles demonstrated potent and excellent photocatalytic degradation performance for TC (91.09%), AMP (87.97%), and AMX (92.42%) antibiotics within 210, 180, and 150 min of visible light irradiation. Co-ZnO nanoparticles also demonstrated strong antimicrobial performance against Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Aspergillus flavus, Aspergillus niger, and Bacillus subtilis. Further investigation of in vitro cytotoxic potential against the A549 cell line (IC 50 = 24 ± 0.5 μg/mL) utilizing MTT assay and the free radical scavenging performance of Co-ZnO nanoparticles estimated by DPPH assay utilizing L-ascorbic acid as a reference was also performed. Antiinflammatory potential is also reviewed by comparing it with the standard drug Diclofenac, and the maximum activity was obtained for Ni-ZnO nanoparticles (IC 50 = 72.4 μg/mL).