Chitosan is a nontoxic, biodegradable, and biocompatible polysaccharide of β(1-4)-linked d-glucosamine and N-acetyl-d-glucosamine. This derivative of natural chitin presents remarkable properties that have paved the way for the introduction of chitosan in the biomedical and pharmaceutical fields. Nevertheless, the properties of chitosan, such as its poor solubility in water or in organic solvents, can limit its utilization for a specific application. An elegant way to improve or to impart new properties to chitosan is the chemical modification of the chain, generally by grafting of functional groups, without modification of the initial skeleton in order to conserve the original properties. The functionalization is carried out on the primary amine group, generally by quaternization, or on the hydroxyl group. This review aims to provide an overview of chitosan and chitosan derivatives used for drug delivery, with a special emphasis on chemical modifications of chitosan to achieve specific biomedical purpose. The synthesis of the main chitosan derivatives will be reviewed. The applications of chitosan and these chitosan derivatives will be illustrated.