Additive manufacturing has enabled significant advances in fabricating 3D-printed microneedle (MN) systems by broadening the range of printable materials and processing strategies. This chapter focuses on recent developments in materials and manufacturing approaches that enhance the functionality and performance of MN devices. Innovative material classes, including biodegradable polymers and stimuli-responsive hydrogels, are discussed with respect to their suitability for controlled drug delivery and minimally invasive applications. Emerging printing technologies such as continuous liquid interface production, multi-material printing, and hybrid additive–subtractive methods are highlighted for their ability to improve fabrication speed, structural complexity, and material integration. The chapter also addresses advances in surface modification and functionalization, including nanocoatings, which improve mechanical strength, biocompatibility, and drug loading efficiency. In addition, drug encapsulation strategies compatible with additive manufacturing are reviewed, emphasizing their role in achieving precise and efficient therapeutic delivery. Finally, this chapter outlines key manufacturing innovations shaping the next generation of 3D-printed microneedle systems.