Antimicrobial thin films are types of protective coatings that are applied to surfaces such as medical devices, food packaging materials, water-resistant coatings, and other systems. These films prevent and reduce the spread of microbial organisms, including bacteria, fungi, and viruses. Antimicrobial thin films can be prepared from a variety of nanostructured materials including metal nanoparticles, metal oxides, plant materials, enzymes, bacteriocins and polymers. Their antimicrobial mechanism varies mostly based on the types of active agents from which the film is made of. Antimicrobial thin films are becoming increasingly popular microbial treatment methods due to their advantages such as enhanced stability, reduced toxicity levels, extended effectiveness over time and broad spectrum antimicrobial action without side effects on human health or the environment. This popularity and enhanced performance is mainly due to the extended possibility of film designs. Thin films offer convenient formulation methods which makes them suitable for commercial practices aiming at high turnover rates along with residential applications requiring frequent application cycles. This review focuses on recent developments in the possible processing methods and design approaches for assembling the various types of antimicrobial materials into nanostructured thin film-based delivery systems, along with mechanisms of action against microbes.