The use of textiles in medicine dates back to ancient times. In modern medicine, textile fibers can be found in a wide variety of biomedical devices from simple non-woven bandages for wounds to complex hollow fiber membranes in artificial lungs. The combination of biotechnology and textile engineering could improve the performance of biomedical textiles or produce novel textile components for biomedical devices. This chapter overviews the recent progress of enzyme biotechnology for biomedical textiles in three different aspects: i) enzymes as tools for fiber functionalization, ii) enzymes immobilized on textiles carriers for therapeutic or bioanalytical application, and iii) enzymatically responsive textiles. Innovative technologies for upgrading the functional properties of biomedical textiles are also considered.