Biofilm formation on textile surfaces has garnered significant attention due to its implications across diverse sectors, including healthcare and industry. Textiles, as essential components of daily life, are particularly vulnerable to biofilm initiation due to sweat absorption during wear. Notably, biofilm persistence on healthcare textiles, such as hospital linens and uniforms, is a critical contributor to healthcare-associated infections (HAIs). Inadequate laundering practices allow pathogenic bacterial strains to adhere to fabrics, exacerbating infectious disease transmission while compromising material functionality and durability. Additionally, physicochemical properties of textiles such as surface charge, chemical composition, and hydrophilicity/hydrophobicity play pivotal roles in bacterial adhesion, the foundational step in biofilm formation. Once established, biofilm eradication becomes exceedingly challenging. Consequently, pretreatment strategies targeting both antimicrobial and antibiofilm activity have been developed to mitigate these issues. This chapter explores the mechanisms underlying biofilm development on various fabric materials (natural and synthetic), factors influencing microbial adhesion, associated challenges, detrimental consequences, and strategies for biofilm removal. Moreover, advancements in innovative approaches have been discussed which emphasize the urgent need for next-generation functional textiles engineered with anti-adhesion properties. Prospects for future research include refining fabric pretreatment protocols and developing textiles impregnated with antimicrobial and antibiofilm agents. Such innovations aim to foster healthier environments in daily life, healthcare settings, and industrial applications by sustainably addressing biofilm-related challenges.