The design and synthesis of macromolecules, i.e. macromolecular engineering, employ specific synthetic tools for the control over the functionality, topology, and composition of a macromolecule. In terms of macromolecular engineering, 2‐oxazolines present an attractive monomer class for the design of a structurally diverse set of macromolecules, as a wide array of monomer structures can be prepared via established synthetic pathways and macromolecules have been prepared from this monomer by cationic ring‐opening, zwitterionic, anionic, and radical polymerization techniques. Most prominently applied, however, is the cationic ring‐opening polymerization, since it is compatible with a wide range of 2‐oxazoline monomers and the living polymerization mechanism allows excellent control over the macromolecular architecture throughout the different steps of the polymerization. Furthermore, the obtained poly(2‐alkyl/aryl‐2‐oxazoline)s (PAOx) display excellent physical and chemical stability, as well as an overall biocompatible nature. These factors combined have led to a recent rise in popularity of PAOx as a highly modular polymer platform in biomedicine, where cutting‐edge macromolecular engineering is applied to face current challenges in biomedicine. In this article, the current state and opportunities in the macromolecular engineering of PAOx are discussed in great detail, thereby providing an overview of the developed synthetic methodologies to control their functionality, topology, and composition.