Dextran is a complex, branched and hydrophilic polysaccharide composed of anhydroglucose rings. This chapter highlights recent progress in the synthesis of new materials based on dextran. It summarizes recent developments in the preparation of dextran derivatives with a focus on the chemical structure which make these materials, e.g. applicable as prodrugs, bioactives, hydrogels or nanogels, nanoparticles and self-assembled structures for surface modification. Novel materials with properties intended for specific applications are for example nanoparticle formulations in the field of drug delivery systems and 3D scaffold materials useful in the tissue regeneration field. A number of reviews have been published on dextrans covering subjects like material production through biotechnological processes up to the chemical modification of this material. Dextran is degraded enzymatically by dextranase, which is present in the human body in the colon, spleen, kidneys and lungs. This enzymatic degradation can be regarded important in the application of dextran and dextran conjugates.