Abstract <p>In recent years, people’s functional requirements for textile materials have increased, and public health concerns have also drawn significant attention to innovative methods and technologies for bacteriostasis. Quaternary ammonium salts (QASs) are widely used in the textile industry as powerful antibacterial surface materials, but people prefer composite functional textiles over single antibacterial agents. Although extensive research has been conducted to develop these materials, there is still limited literature on the systematic study of QAS-based composite functional textiles. This review provides a comprehensive overview of related fields in textile materials. First, it introduces the types and synthesis methods of QASs, analyzes their chemical structure–activity relationships, and discusses their antibacterial coating finishing on the surface of textiles. Then, it examines the antibacterial functionalization of QAS textile surfaces, along with potential additional functionalities. Finally, it presents perspectives on future developments in QASs and the textile industry, including stimuli-responsive degradable QAS textiles. Although these areas remain underexplored, significant potential for growth exists. It is anticipated that this review will serve as a valuable reference for the ongoing development of QAS-based composite functional textiles.</p> Graphical abstract <p></p>