Mesoporous bioactive glasses (MBGs) are a class of modern porous nanomaterials with significant biological activity, appealing physicochemical properties, and desirable morphological features. They have potential applications in various fields, including adsorption, separation, catalysis, bioengineering, and medicine. However, primitive MBGs face challenges in biomedical applications, such as weak encapsulation efficiency, drug loading, and mechanical strength. Incorporating supramolecular assemblies, metal species, and their conjugates into MBGs can preserve their advantageous attributes. Recent advancements in MBGs have enabled novel applications, such as stimuli-responsive drug delivery, with exceptional in vivo performance. This review outlines the fabrication process of calcium-silicon-phosphorus-based MBGs, discusses their progress in engineered strategies involving surface functionalization, nanostructures, and network modification, and emphasizes recent advancements in their textural and physicochemical properties, as well as their theranostic potentials in multiple diseases. The review also highlights the importance of bench-to-bedside considerations for MBGs to transition from the laboratory to the clinic. MBGs have been developed with various topographic and structural characteristics, such as particles, microspheres, fibers, 3D-printing scaffolds, and hierarchical structures. Surface functionalization, nanostructured modification, and network modification have been explored to enhance MBGs for applications in drug delivery, theranostics, and tissue regeneration. The review discusses the role of surface chemistry, nanostructured features, and modified networks in improving drug delivery efficiency and immune rejection. MBGs have been modified with various components, such as polymers, peptides, and molecules, to achieve surface modification. The review also highlights the potential of MBGs in catalysis, separation, adsorption, biosensing, and controlled drug delivery. The review emphasizes the importance of optimizing MBGs for clinical applications, considering factors such as particle size, shape, and surface functionality. The review concludes that MBGs have significant potential for disease theranostics and biomedical applications, with ongoing research aimed at improving their performance and safety for clinical translation.Mesoporous bioactive glasses (MBGs) are a class of modern porous nanomaterials with significant biological activity, appealing physicochemical properties, and desirable morphological features. They have potential applications in various fields, including adsorption, separation, catalysis, bioengineering, and medicine. However, primitive MBGs face challenges in biomedical applications, such as weak encapsulation efficiency, drug loading, and mechanical strength. Incorporating supramolecular assemblies, metal species, and their conjugates into MBGs can preserve their advantageous attributes. Recent advancements in MBGs have enabled novel applications, such as stimuli-responsive drug delivery, with exceptional in vivo performance. This review outlines the fabrication process of calcium-silicon-phosphorus-based MBGs, discusses their progress in engineered strategies involving surface functionalization, nanostructures, and network modification, and emphasizes recent advancements in their textural and physicochemical properties, as well as their theranostic potentials in multiple diseases. The review also highlights the importance of bench-to-bedside considerations for MBGs to transition from the laboratory to the clinic. MBGs have been developed with various topographic and structural characteristics, such as particles, microspheres, fibers, 3D-printing scaffolds, and hierarchical structures. Surface functionalization, nanostructured modification, and network modification have been explored to enhance MBGs for applications in drug delivery, theranostics, and tissue regeneration. The review discusses the role of surface chemistry, nanostructured features, and modified networks in improving drug delivery efficiency and immune rejection. MBGs have been modified with various components, such as polymers, peptides, and molecules, to achieve surface modification. The review also highlights the potential of MBGs in catalysis, separation, adsorption, biosensing, and controlled drug delivery. The review emphasizes the importance of optimizing MBGs for clinical applications, considering factors such as particle size, shape, and surface functionality. The review concludes that MBGs have significant potential for disease theranostics and biomedical applications, with ongoing research aimed at improving their performance and safety for clinical translation.