The research on porous silicon (PSi) materials for biomedical applications has expanded greatly since the early studies of Leigh Canham more than 25 years ago. Currently, PSi nanoparticles are receiving growing attention from the scientific biomedical community. These nanostructured materials have emerged as promising multifunctional and versatile platforms for nanomedicine in drug delivery, diagnostics and therapy. The outstanding properties of PSi, including excellent in vivo biocompatibility and biodegradability, have led to many applications of PSi for delivery of therapeutic agents. In this review, we highlight current advances and recent efforts on PSi nanoparticles regarding the production properties, efficient drug delivery, multidrug delivery, permeation across biological barriers, biosafety and in vivo tracking for biomedical applications. The constant boost on successful preclinical in vivo data reported so far makes this the ‘golden age’ for PSi, which is expected to finally be translated into the clinic in the near future.