Borosilicate bioactive glass promises broad application prospects in biomedical field because of the controllable degradation, hydroxyapatite convertibility in situ, biocompatibility, bond-ability with hard and soft tissues, strong tissue repair and regeneration capability. This review briefly represented recent development and application of borosilicate bioactive glass and its derived materials, and some research work on the multifunctional modification of borosilicate bioactive glass via functional element doping, organic-inorganic hybrid composition, and construction of micro/nano-structure. The latest achievements in tissue repair, tumor therapy, drug delivery and other fields were summarized. In addition, the prospects and challenges of borosilicate bioactive glass were also discussed.