Porous polymers, including hydrogels, covalent organic frameworks (COFs), and hyper crosslinked polymers (HCPs), have become essential in biomedical research for their tunable pore architectures, large surface areas, and functional versatility. This review provides a comprehensive overview of their classification and updated synthesis mechanisms, such as 3D printing, electrospinning, and molecular imprinting. Their pivotal roles in drug delivery, tissue engineering, wound healing, and photodynamic/photothermal therapies, focusing on how pore size, distribution, and architecture impact drug release, cellular interactions, and therapeutic outcomes, are explored. Key challenges, including biocompatibility, mechanical strength, controlled degradation, and scalability, are critically assessed alongside emerging strategies to enhance clinical potential. Finally, recent challenges and future perspectives, emphasizing the broader biomedical applications of porous polymers, are addressed. This work provides valuable insights for advancing next-generation biomedical innovations through these materials.