Cellulose-based aerogels (CBAs) have emerged as highly promising drug carriers due to their ultralow density, exceptional porosity (>99%), high specific surface area, and biocompatibility. They serve as versatile platforms for efficient drug loading, protection against degradation, and precise spatiotemporal control of drug release. This chapter reviews recent advances in the development and application of CBAs in diverse drug delivery scenarios, including antibacterial wound healing, tissue repair, hemostasis, and intelligent responsive release. Through various functionalization strategies, such as surface modification with bioactive groups, incorporation of nanoparticles, and design of hierarchical or core–shell structures, CBAs demonstrate enhanced drug loading capacity, tunable release profiles and multifunctionality. While in vitro and preclinical studies showcase significant potential, challenges such as precise morphology/size control, long-term in vivo performance validation, clinical scalability, and complex release mechanism understanding remain. Continued research is crucial to address these limitations and advance CBAs towards clinical translation. Overall, CBAs offer a sustainable, adaptable, and effective platform for next-generation intelligent and targeted drug delivery systems.