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Inspired by nature's antimicrobial topographies, micro\/nanostructured mechano\u2010antibacterial surfaces have been widely studied. This review summarizes the materials and antimicrobial effects of various natural and biomimetic micro\/nanostructured surfaces, and their antifouling and bactericidal mechanisms are elucidated systematically. The synergistic antifouling and bactericidal surfaces are also described, as well as the synergistic antibacterial mechanisms, advantages, and disadvantages. Subsequently, the influential factors and design principles of biomimetic antibacterial surfaces are discussed, including surface morphology, roughness, wettability, bacterial species, and motility characteristics. Multiple factors intertwining makes it difficult to interpret the antimicrobial behavior of surfaces. Finally, the fabrication methods of bio\u2010inspired micro\/nanostructured surfaces have been presented. The challenges are achieving high bactericidal efficacy alongside biocompatibility, long\u2010term stability, facile fabrication of precise architectures, and adaptive surface functionalization. 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