Biofilms are complex microbial communities that adhere to surfaces and are embedded in an extracellular matrix composed of DNA, proteins, and polysaccharides, making them highly resistant to antibiotics. They are a major cause of persistent infections, especially in hospital settings, and contribute to chronic diseases like tuberculosis and other drug-resistant infections. Biofilm formation is regulated by quorum sensing and involves multiple steps, including initial adhesion, EPS production, and maturation. Biofilms provide protection against antibiotics and the immune system, enhancing bacterial survival and resistance. Antibiotic resistance in biofilms is due to factors such as reduced permeability, efflux pumps, and altered gene expression. Biofilms can also enter a dormant state, increasing their resistance to antibiotics. Horizontal gene transfer and the presence of persister cells further contribute to antibiotic resistance. Alternative approaches to combat biofilm-related infections include CRISPR-Cas gene editing, photodynamic therapy (PDT), and the use of nanoparticles. These methods target biofilm structure and function, enhancing antibiotic efficacy. Additionally, biofilm dispersal agents and inhibitors of quorum sensing are being explored as potential therapies. The study highlights the importance of understanding biofilm mechanisms to develop new treatments for drug-resistant infections. Future research should focus on targeting biofilm formation and resistance mechanisms to improve therapeutic outcomes.Biofilms are complex microbial communities that adhere to surfaces and are embedded in an extracellular matrix composed of DNA, proteins, and polysaccharides, making them highly resistant to antibiotics. They are a major cause of persistent infections, especially in hospital settings, and contribute to chronic diseases like tuberculosis and other drug-resistant infections. Biofilm formation is regulated by quorum sensing and involves multiple steps, including initial adhesion, EPS production, and maturation. Biofilms provide protection against antibiotics and the immune system, enhancing bacterial survival and resistance. Antibiotic resistance in biofilms is due to factors such as reduced permeability, efflux pumps, and altered gene expression. Biofilms can also enter a dormant state, increasing their resistance to antibiotics. Horizontal gene transfer and the presence of persister cells further contribute to antibiotic resistance. Alternative approaches to combat biofilm-related infections include CRISPR-Cas gene editing, photodynamic therapy (PDT), and the use of nanoparticles. These methods target biofilm structure and function, enhancing antibiotic efficacy. Additionally, biofilm dispersal agents and inhibitors of quorum sensing are being explored as potential therapies. The study highlights the importance of understanding biofilm mechanisms to develop new treatments for drug-resistant infections. Future research should focus on targeting biofilm formation and resistance mechanisms to improve therapeutic outcomes.