Catalytic biomaterials represent a cutting-edge interdisciplinary research frontier that bridges biomimetic chemistry with advanced materials science. By harnessing the intrinsic catalytic properties of engineered materials and incorporating precisely tunable nanostructures, these systems offer transformative strategies to address the inherent limitations of conventional therapeutic modalities. A key advantage of catalytic biomaterials lies in their finely controlled composition, morphology, and surface chemical functionalities, which collectively enable the targeted modulation of critical biochemical reactions within pathological microenvironments. Such modulation facilitates the localized and sustained generation of bioactive species, thereby enhancing therapeutic specificity and efficacy while simultaneously minimizing systemic toxicity and adverse effects. This review systematically elucidates the fundamental design principles and optimization strategies for constructing catalytic biomaterials, explores their mechanistic pathways in disease modulation, and highlights their translational potential in clinical pancatalytic disease treatments. Furthermore, it identifies and discusses the major scientific and technological challenges that must be addressed to advance the clinical integration of these promising therapeutic platforms.