Zinc oxide nanostructures (ZnO NSs) are one of the most versatile and promising metal oxides having significant importance in biomedical fields, especially for therapeutic and diagnostic purposes. ZnO possesses unique physio-chemical and biological properties such as photo-chemical stability, corrosion resistance, mechanical properties, biocompatibility, higher targeting capability, and ROS-triggered cytotoxicity. These ZnO NSs enhance their potential for various biomedical applications such as cancer therapy, drug delivery, bioimaging, tissue engineering, etc. Furthermore, ZnO possesses excellent luminescent properties that make it useful for bioimaging and image-guided targeted drug delivery, thereby reducing the unwanted side effects of chemotherapeutic agents. Besides, these characteristics, enhanced permeability and retention (EPR) effect, electrostatic interaction, ROS production, and pH-dependent dissolution of ZnO also make them potential aspirants as therapeutics that are suggested as keys parameter for cytotoxic and cell death mechanisms via apoptosis, autophagy, and mitophagy mechanism. Here, the recent progress and advances of ZnO NSs in bioimaging, drug delivery, and tissue engineering are discussed along with the advantages, limitations, and future advancement for biological applications.