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Conventional blood\u2010contacting coatings predominantly focus on singular antibacterial or anticoagulant functions, while clinical demands urgently require surfaces with synergistic \"antibacterial\u2010anticoagulant\" efficacy to address complex biofouling challenges. Recent advancements in dual\u2010functional antibacterial\u2010anticoagulant coatings have achieved notable progress. This review summarizes four representative categories: (1) antimicrobial\u2010dominant antifouling coatings, which combine active bactericidal mechanisms to inhibit biofilm formation with passive antifouling strategies to suppress thrombogenesis; (2) anticoagulant\u2010loaded bifunctional coatings, merging sustained\u2010release anticoagulant agents with antibacterial active components or antifouling layers to achieve dual active defense; (3) physically biomimetic bifunctional coatings, leveraging micro\/nanotopological architectures and surface chemical mimicry to disrupt bacterial adhesion and platelet activation simultaneously; and (4) environment\u2010responsive smart coatings, enabling stimuli\u2010responsive dynamic switching of antibacterial functions to adapt to in vivo microenvironmental changes. This review discusses the design principles and operational mechanisms of coatings while highlighting persistent challenges. 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