Antimicrobial peptides (AMPs) are amphipathic molecules that interact with bacterial membranes, leading to membrane disruption and cell death. They are naturally produced in various organisms, including humans, animals, plants, and microorganisms. AMPs are part of the innate immune system in higher animals, where they combat infections caused by bacteria, fungi, viruses, and parasites. They can be designed de novo or selected from combinatorial libraries and produced chemically or recombinantly. Despite their potential as antibiotics, few have reached the market due to stability and toxicity issues. This review discusses the development and clinical trials of AMPs, their current status in the pharmaceutical industry, and their therapeutic market. Modifications to improve stability and bioavailability are also described. The review highlights the challenges in AMP development, including resistance, toxicity, and the need for chemical modifications. AMPs are being explored for clinical applications, with some in clinical trials for various infections. Strategies such as PEGylation, lipidation, cyclisation, and the use of branched peptides are being employed to enhance AMP stability and reduce toxicity. Nanocarriers are also being investigated to improve the delivery and safety of AMPs. Despite challenges, AMPs remain a promising area of research for new antimicrobial drugs.Antimicrobial peptides (AMPs) are amphipathic molecules that interact with bacterial membranes, leading to membrane disruption and cell death. They are naturally produced in various organisms, including humans, animals, plants, and microorganisms. AMPs are part of the innate immune system in higher animals, where they combat infections caused by bacteria, fungi, viruses, and parasites. They can be designed de novo or selected from combinatorial libraries and produced chemically or recombinantly. Despite their potential as antibiotics, few have reached the market due to stability and toxicity issues. This review discusses the development and clinical trials of AMPs, their current status in the pharmaceutical industry, and their therapeutic market. Modifications to improve stability and bioavailability are also described. The review highlights the challenges in AMP development, including resistance, toxicity, and the need for chemical modifications. AMPs are being explored for clinical applications, with some in clinical trials for various infections. Strategies such as PEGylation, lipidation, cyclisation, and the use of branched peptides are being employed to enhance AMP stability and reduce toxicity. Nanocarriers are also being investigated to improve the delivery and safety of AMPs. Despite challenges, AMPs remain a promising area of research for new antimicrobial drugs.