Abstract Polyvinyl alcohol (PVA) is well-known for its excellent mechanical properties and eco-friendliness in food packaging. Recently, PVA has gained significant attention in research due to its potential as antibacterial substrates. However, because of its high hydrophilicity, practical application of pure PVA film has been limited by low water resistance and rapid bacterial growth in humid conditions. Diverse effective strategies have been developed to decrease hydrophilicity and endow films with antibacterial properties. This review provides an overview of universal antibacterial agents and their functions in PVA-based packaging films. It also introduces the changes in the mechanical and physical properties of PVA-based films after adding antibacterial agents. Additionally, the release behavior of antibacterial agents in PVA-based film materials and their practical applications in the food industry is discussed in fresh food packaging. Biodegradability of PVA-based films is also mentioned, with a promising future for more effective and eco-friendly food packaging materials.