<p>Metal-Organic Frameworks (MOFs) have emerged as a versatile class of crystalline porous materials associated with exceptional surface area, diverse chemical functionality and tunable pore architecture. Recent progresses in structural chemistry and engineering have enabled the rational design of MOFs with tailored properties, including defect-engineered frameworks, hybrid composites and flexible structures. The innovative synthetic strategies such as microwave assisted synthesis and other fabrication methods are addressing challenges related to scalability, environmental and cost impact. These developments have significantly expanded applicability of MOFs in critical domain like wastewater treatment and drug delivery. In wastewater treatment, MOFs exhibit high efficiency in adsorption and catalytic degradation of wide range of pollutants such as heavy metals, dyes, and emerging contaminants because of their high porosity and functionalizable active sites. In addition, MOF based membranes offer enhanced recyclability and selectivity. In biomedical applications, MOFs considered as a promising drug delivery platform due to their high loading capacity, stimuli responsive characteristics, controlled release behaviour, enabling sustained and targeted therapeutics. Despite these advancements, challenges such as stability in aqueous and physiological atmosphere, biocompatibility and large scale implementation remain critical concern. Hence, the present review highlights recent trends in structural design and synthesis of MOFs and discussing their growing potential in wastewater treatment and drug delivery, while addressing limitations and future research directions for their practical development.</p> Graphical Abstract <p></p>