Abstract Polyurethane (PU) composites have received increasing attention due to their enhanced properties and functions when compared with sole PU, and PU nanocomposites are superior to larger-sized ones to some extent. The suitable and successful combination of PU and other materials, such as polymer, carbon-based material, and bioceramic, will impart the composites with great potential to be applied in different biomedical fields, including wound dressing, tissue engineering, drug delivery and biosensor. This chapter reviews the current state of PU composite fabrication, the corresponding properties and functions. Particularly, the typical characteristics and preparation techniques are reviewed, and then several types of popular PU composites, as well as the corresponding applications in biomedical fields are summarized and discussed, such as PU–polymer type for wound dressing and PU–ceramic type for tissue engineering. The composites with unique functions or fabricated using functional PU, like shape memory polyurethane (SMPU), are highlighted and discussed, including their physicochemical, mechanical, thermal, and biological performance. Finally, the perspectives and challenges of PU composites are suggested, and the conception of potential possibilities to better apply such composites is also presented.