Silk from the silkworm, Bombyx mori, has been used as a biomedical suture for centuries due to its unique mechanical properties. However, some biocompatibility issues have been reported, likely due to residual sericin (glue-like proteins). Recent studies show that core silk fibroin fibers are biocompatible and comparable to other biomaterials like polylactic acid and collagen. Silk's unique mechanical properties, diverse side chain chemistries for growth factors, and genetic tailoring make it a promising biomaterial. For tissue engineering, silk's properties support bone and ligament formation in vitro. Silk-like proteins from spiders and insects offer diverse variants for clinical applications. Silk is a protein polymer spun by lepidoptera larvae, including silkworms and spiders. Silkworm silk contains two fibroin proteins, light and heavy chains, encased in sericin. Spider silk, though not commercialized for biomedical use, has unique mechanical properties and is being genetically engineered. Recent advances in understanding silk's genetic and protein structures have enabled the production of genetically engineered spider silk proteins. Silk's environmental stability, biocompatibility, and genetic control make it valuable for biomedical applications. Silk's mechanical properties, including strength and toughness, make it suitable for biomedical applications. However, silk matrices have been reconsidered for clinical repairs and tissue engineering scaffolds. Silk is a potential allergen, causing Type I allergic reactions. Black braided silk, with sericin removed, is less likely to cause hypersensitivity. Silk's degradation is influenced by proteolytic enzymes and foreign body responses. In vitro studies show silk degrades over time, with proteases cleaving less-crystalline regions. Silk is used in tissue engineering for scaffolds, offering versatility in matrix design. Silk fibroin can be processed into foams, films, fibers, and meshes. Studies show silk supports cell growth and bone tissue formation. Silk's mechanical properties and ability to mimic native tissues make it suitable for ligament and bone tissue engineering. Silk-based matrices, such as wire-rope matrices, offer controlled mechanical properties and support tissue ingrowth. Silk's high tensile strength and slow degradation make it suitable for long-term applications. Silk's potential in tissue engineering is promising, with ongoing studies to optimize matrix geometry and stiffness for tissue ingrowth. Silk's unique properties, including mechanical strength, biocompatibility, and degradation, make it a valuable biomaterial for biomedical applications.Silk from the silkworm, Bombyx mori, has been used as a biomedical suture for centuries due to its unique mechanical properties. However, some biocompatibility issues have been reported, likely due to residual sericin (glue-like proteins). Recent studies show that core silk fibroin fibers are biocompatible and comparable to other biomaterials like polylactic acid and collagen. Silk's unique mechanical properties, diverse side chain chemistries for growth factors, and genetic tailoring make it a promising biomaterial. For tissue engineering, silk's properties support bone and ligament formation in vitro. Silk-like proteins from spiders and insects offer diverse variants for clinical applications. Silk is a protein polymer spun by lepidoptera larvae, including silkworms and spiders. Silkworm silk contains two fibroin proteins, light and heavy chains, encased in sericin. Spider silk, though not commercialized for biomedical use, has unique mechanical properties and is being genetically engineered. Recent advances in understanding silk's genetic and protein structures have enabled the production of genetically engineered spider silk proteins. Silk's environmental stability, biocompatibility, and genetic control make it valuable for biomedical applications. Silk's mechanical properties, including strength and toughness, make it suitable for biomedical applications. However, silk matrices have been reconsidered for clinical repairs and tissue engineering scaffolds. Silk is a potential allergen, causing Type I allergic reactions. Black braided silk, with sericin removed, is less likely to cause hypersensitivity. Silk's degradation is influenced by proteolytic enzymes and foreign body responses. In vitro studies show silk degrades over time, with proteases cleaving less-crystalline regions. Silk is used in tissue engineering for scaffolds, offering versatility in matrix design. Silk fibroin can be processed into foams, films, fibers, and meshes. Studies show silk supports cell growth and bone tissue formation. Silk's mechanical properties and ability to mimic native tissues make it suitable for ligament and bone tissue engineering. Silk-based matrices, such as wire-rope matrices, offer controlled mechanical properties and support tissue ingrowth. Silk's high tensile strength and slow degradation make it suitable for long-term applications. Silk's potential in tissue engineering is promising, with ongoing studies to optimize matrix geometry and stiffness for tissue ingrowth. Silk's unique properties, including mechanical strength, biocompatibility, and degradation, make it a valuable biomaterial for biomedical applications.