Nowadays, living therapeutics is a promising candidate among various therapies, and oral administration of living therapeutics characterized by universality and safety avail to make the transition from bench to bedside. However, precise delivery and continuous maintenance of cell viability and activity to acquire stable and ideal therapeutic efficacy remain challenging. Living material is the smart integration of the flexibly programmable functionality of biomaterial and the autonomous environmental responsiveness of living elements, heralding a new era of biotherapeutics in addressing human health concerns. Here, our review aims at presenting an overview of the status of the oral delivery of living material from a biological, technical, and practical perspective, describing the clinical significance and potential, the current technological development and dilemma, as well as the prospect.