Airborne pathogens, though a minor fraction of airborne particles, can cause infections, intoxications, or allergic reactions through respiration, dermal contact, or ingestion. The SARS-CoV-2 pandemic has underscored the significance of mitigating airborne microbial threats. Traditional air ionization methods, such as dielectric barrier discharge and metal tip corona discharge, produce ozone, a reactive and potentially harmful byproduct. However, carbon-fiber ionizers (CFIs) generate high concentrations of ions with minimal ozone production, making them a safer alternative. Operating at voltages below 5 kV, CFIs are more efficient than their metallic counterparts. This review focuses on the antimicrobial efficacy of CFIs, which produce unipolar ions that can disrupt microbial membranes, leading to cell death. Compared to ultraviolet light sterilization, CFIs are cost-effective and suitable for small spaces. The literature review highlights the need for comprehensive studies to evaluate the real-world application and effectiveness of CFIs. Many existing studies are limited by small-scale testing and insufficient data reporting, complicating comparative analyses. Our work aims to provide a detailed perspective on CFIs, examining their impact on various microorganisms, ion efficacy, ionization outcomes, and ozone generation levels. By addressing these aspects, the review seeks to offer an updated understanding of CFIs’ antimicrobial capabilities and to identify limitations in current research, paving the way for more informed and effective air purification strategies.