Polymer vesicles, hollow nanostructures with hydrophilic cavity and hydrophobic membrane, have shown significant potentials in biomedical applications including drug delivery, gene therapy, cancer theranostics, and so forth, due to their unique cell membrane-like structure. Incorporation with antibacterial active components like antimicrobial peptides, etc., polymer vesicles exhibited enhanced antimicrobial activity, extended circulation time, and reduced cell toxicity. Furthermore, antibacterial, and anticancer can be achieved simultaneously, opening a new avenue of the antimicrobial applications of polymer vesicles. This review seeks to highlight the state-of-the-art of antimicrobial polymer vesicles, including the design strategies and potential applications in the field of antibacterial. The structural features of polymer vesicles, preparation methods, and the combination principles with antimicrobial active components, as well as the advantages of antimicrobial polymer vesicles, will be discussed. Then, the diverse applications of antimicrobial polymer vesicles such as wide spectrum antibacterial, anti-biofilm, wound healing, and tissue engineering associated with their structure features are presented. Finally, future perspectives of polymer vesicles in the field of antibacterial is also proposed.