Hydrogel films have emerged as versatile platforms in biomedical engineering due to their unique physicochemical properties, biocompatibility, and adaptability to diverse therapeutic needs. This review provides a comprehensive overview of hydrogel film materials, including natural biopolymers, synthetic polymers, and multifunctional composites, highlighting their structural and functional diversity. We examine key fabrication techniques-ranging from solvent casting and photopolymerization to advanced methods like microfluidics and 3D printing-and discuss how these influence film architecture and performance. The biomedical applications of hydrogel films span wound healing, drug delivery, tissue engineering, ophthalmology, and implantable biosensors, with recent innovations enabling stimuli-responsive behavior, multi-drug loading, and integration with wearable electronics. Despite their promise, hydrogel films face persistent challenges in mechanical durability, sterilization, storage stability, regulatory approval, and scalable manufacturing. We conclude by identifying critical research gaps and outlining future directions, including AI-guided design, sustainable material development, and the establishment of standardized, regulatory-aligned, and industrially scalable fabrication strategies to accelerate clinical translation.