<p>Biomedical materials of natural origin possess excellent structural, mechanical, and biodegradable properties, as well as a high degree of biocompatibility and potential for chemical modification. As a result, they are among the key components in regenerative medicine, providing a basis for successful strategies in gene therapy, cell therapy, tissue engineering, and drug delivery systems. The development and manufacturing of innovative medical products based on such materials make it possible to improve living standards and correspond to the priority areas of scientific and technological development of the Russian Federation. A special place among the natural sources is is occupied by silkworm (<i>Bombyx mori</i>), which can be used as a highly efficient and easily scalable biological system for obtaining various biologically active molecules. Molecular engineering of the silkworm based on the methods of transient expression or stable transformation of germplasm (transgenic silkworms) makes it possible to use the silkworm as a bioreactor for a wide range of recombinant biomaterial derivatives. The cocoon shell is a source of unique natural protein-based biopolymers, such as fibroin and sericin. The combination of silkworm-based biotechnological solutions employing both bottom-up and top-down approaches presents a promising manufacturing platform for a wide range of biomaterials and bioactive molecules applicable across various fields of medicine: from bone scaffolds to corneal transplant films. This review focuses on the latest advances in the use of biomaterials of a manufacturing platform for cartilage regeneration and also explores its potential in other biomedical applications.</p>