Transition metal oxide (TMO) nanomaterials have emerged as versatile antimicrobial platforms at a time when antimicrobial resistance (AMR) is eroding the utility of conventional drugs. Their rich defect chemistry, redox activity, and tunable band structures enable multiple microbicidal pathways, including reactive oxygen species generation, membrane disruption, metal-ion release, and biomolecular damage. A large body of work now reports antimicrobial TMOs. Yet, existing reviews are often limited to individual oxides, a single synthesis route, or specific applications, and rarely connect synthesis, structure, and mechanism across biomedical and technological contexts. This review provides an integrated, state-of-the-art overview of antimicrobial TMOs, with emphasis on widely studied systems such as ZnO, CuO, TiO₂, and Fe₃O₄. We critically summarize physical, chemical, and green/bio-inspired synthesis routes and their influence on size, morphology, surface chemistry, and defect structures, as revealed by XRD, electron microscopy, vibrational, and optical spectroscopies. Antimicrobial mechanisms are discussed alongside standard assays, including planktonic and biofilm models. Finally, we highlight applications in medicine, water treatment, food packaging, agriculture, personal care products, and textiles, and outline key challenges in toxicity, scalability, and standardization. By linking synthesis–structure–mechanism–application, this review identifies design principles for the next generation of safe, effective TMO-based antimicrobials with a focus on translational implementation.
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