This review discusses recent advances in the fabrication of decellularized extracellular matrix (dECM)-based composite materials for skin tissue engineering. Chronic wound management is a significant medical challenge, and dECM-based materials have shown promising biological properties for tissue regeneration. However, the complex external environment and the long healing process of chronic wounds hinder the application of pure dECM materials. To address these challenges, dECM-based composite materials have been developed to promote wound healing, featuring antimicrobial activity and suitable degradability. The fabrication technologies for designing wound dressings with various forms, such as molded hydrogels, electrospun fibers, and bio-printed scaffolds, have expanded the application of dECM-based composite materials. The review highlights the fabrication methods, including molding, electrospinning, and 3D printing, and discusses the associated challenges and prospects in clinical application. The combination of dECM with drugs or other biomaterials has been explored to enhance the performance of these materials, making them more effective in promoting skin regeneration. The review aims to provide a comprehensive understanding of dECM-based composite biomaterials, guiding researchers in choosing suitable fabrication technologies and promoting their clinical translation in skin tissue engineering.This review discusses recent advances in the fabrication of decellularized extracellular matrix (dECM)-based composite materials for skin tissue engineering. Chronic wound management is a significant medical challenge, and dECM-based materials have shown promising biological properties for tissue regeneration. However, the complex external environment and the long healing process of chronic wounds hinder the application of pure dECM materials. To address these challenges, dECM-based composite materials have been developed to promote wound healing, featuring antimicrobial activity and suitable degradability. The fabrication technologies for designing wound dressings with various forms, such as molded hydrogels, electrospun fibers, and bio-printed scaffolds, have expanded the application of dECM-based composite materials. The review highlights the fabrication methods, including molding, electrospinning, and 3D printing, and discusses the associated challenges and prospects in clinical application. The combination of dECM with drugs or other biomaterials has been explored to enhance the performance of these materials, making them more effective in promoting skin regeneration. The review aims to provide a comprehensive understanding of dECM-based composite biomaterials, guiding researchers in choosing suitable fabrication technologies and promoting their clinical translation in skin tissue engineering.