Nucleic acid aptamers, often termed “chemical antibodies”, are functionally comparable to traditional antibodies, but offer several advantages including their relatively small physical size, flexible structure, quick chemical production, versatile chemical modification, high stability, and lack of immunogenicity. In addition, many aptamers internalize upon binding to cellular receptors making them useful targeted delivery agents for siRNAs, microRNAs and conventional drugs. However,Ge several crucial factors, such as their inherent physicochemical characteristics and lack of safety data, have delayed the clinical translation of therapeutic aptamers. This review discusses these challenges, highlighting recent clinical developments and technological advances that have revived impetus for this promising class of therapeutics.