Nanomaterial-based enzyme-mimetic catalysts (Enz-Cats) have received considerable attention because of their optimized and enhanced catalytic performances and selectivities in diverse physiological environments compared with natural enzymes. Recently, owing to their molecular/atomic-level catalytic centers, high porosity, large surface area, high loading capacity, and homogeneous structure, metal-organic frameworks (MOFs) have emerged as one of the most promising materials in engineering Enz-Cats. Here, the recent advances in the design of MOF-engineered Enz-Cats, including their preparation methods, composite constructions, structural characterizations, and biomedical applications, are highlighted and commented upon. In particular, the performance, selectivities, essential mechanisms, and potential structure-property relations of these MOF-engineered Enz-Cats in accelerating catalytic reactions are discussed. Some potential biomedical applications of these MOF-engineered Enz-Cats are also breifly proposed. These applications include, for example, tumor therapies, bacterial disinfection, tissue regeneration, and biosensors. Finally, the future opportunities and challenges in emerging research frontiers are thoroughly discussed. Thereby, potential pathways and perspectives for designing future state-of-the-art Enz-Cats in biomedical sciences are offered.