Nanozymes, an emerging family of heterogeneous nanomaterials with enzyme-like characteristics, offer significant advantages as alternatives to natural enzymes for diverse biocatalytic applications. Nevertheless, the inhomogeneous configuration of nanomaterials makes it extremely challenging to develop nanozymes of desired performance and reaction mechanism. Single-atom nanozymes (SAzymes) that are composed of single-atomic active sites may provide an answer to these challenges with remarkable enzyme-like activity and specificity. The well-defined coordination microenvironments of SAzymes offer a suitable model system to investigate the structure-activity relationship and thus bridge the gap between natural enzyme and nanozyme. In this review, we would first present an overview of discoveries, advantages, and classifications of SAzymes. Then, we would discuss the reaction mechanism, design principles, and biosensing applications of a series of typical SAzymes with a focus on the rational design strategies for targeted reaction and the effort to uncover the catalytic mechanism at the atomic scale. Finally, we would provide the challenges and future perspectives of SAzymes as the next-generation nanozymes.