A surgical suture, also known as a suture, is a medical device used to hold body tissues together and to hold wound edges together after injury or surgery. Surgical sutures are used to facilitate the closure and healing of surgical or traumatic wounds by holding tissues together to facilitate the healing process. There are many different types of suture materials for medical purposes, and the main types are absorbable and non-absorbable. Recently, there has been an increase in the development of classes of suture materials based on their properties and abilities to improve tissue convergence and wound closure. This review describes and discusses current and emerging trends in suture technology, including knotless needle sutures, antimicrobial sutures, bioactive sutures such as drug-eluting and stem cell sutures, and smart sutures, including elastic and electronic sutures. These newer strategies expand the versatility of sutures from being used only as a physical unit that brings opposing tissues closer to a more biologically active component that allows the delivery of drugs and cells to the desired location, with enormous potential for both therapeutic and diagnostic use.