As a kind of star materials, two-dimensional (2D) nanomaterials have attracted tremendous attention for their unique structures, excellent performance and wide applications. In recent years, layered rare earth-based or doped nanomaterials have become a new important member of the 2D nanomaterial family and have attracted significant interest, especially layered rare earth hydroxides (LREHs) and layered rare earth-doped perovskites with anion-exchangeability and exfoliative properties. In this review, we systematically summarize the synthesis, exfoliation, fabrication and biomedical applications of 2D rare earth nanomaterials. Upon exfoliation, the LREHs and layered rare earth-doped perovskites can be dimensionally reduced to ultrathin nanosheets which feature high anisotropy and flexibility. Subsequent fabrication, especially superlattice assembly, enables rare earth nanomaterials with diverse compositions and structures, which further optimizes or even creates new properties and thus expands the application fields. The latest progress in biomedical applications of the 2D rare earth-based or doped nanomaterials and composites is also reviewed in detail, especially drug delivery and magnetic resonance imaging (MRI). Moreover, at the end of this review, we provide an outlook on the opportunities and challenges of the 2D rare earth-based or doped nanomaterials. We believe this review will promote increasing interest in 2D rare earth materials and provide more insight into the artificial design of other nanomaterials based on rare earth elements for functional applications.