Abstract <p>Cellulose, the most abundant and renewable natural polymer, has emerged as a promising platform for developing sustainable antimicrobial materials. Recently, extensive research has focused on cellulose to impart and enhance its antimicrobial properties through diverse strategies. This review presents a comprehensive analysis of recent advances in the chemical, physical, and biological modification of cellulose aimed at boosting its antimicrobial efficacy. Key approaches include the incorporation of metal and metal oxide nanoparticles, surface grafting of cationic moieties, covalent attachment of antimicrobial agents, and blending with naturally derived biocides such as chitosan and essential oils. Mechanisms underlying antimicrobial action, including membrane disruption, oxidative stress, and enzyme inhibition, are also discussed. The review further explores application-specific innovations in fields such as wound healing, medical textiles, food packaging, water purification, and smart coatings. By providing a critical overview of modification-driven enhancement strategies, this review aims to guide future research in designing multifunctional, eco-friendly, and high-performance cellulose-based antimicrobial materials.</p>