Carbon-based quantum dots (CDs) are mainly divided into two sub-groups; carbon quantum dots (CQDs) and graphene quantum dots (GQDs), which exhibit outstanding photoluminescence (PL) properties, low toxicity, superior biocompatibility and facile functionalization. Regarding these features, they have been promising candidates for biomedical science and engineering applications. In this work, we reviewed the efforts made to modify these zero-dimensional nano-materials to obtain the best properties for bio-imaging, drug and gene delivery, cancer therapy, and bio-sensor applications. Five main surface modification techniques with outstanding results are investigated, including doping, surface functionalization, polymer capping, nano-composite and core-shell structures, and the drawbacks and challenges in each of these methods are discussed.