Bispecific antibodies are innovative biotherapeutics that can bind two distinct targets simultaneously, offering new strategies for treating complex diseases like cancer and autoimmune disorders. Their ability to link separate biological pathways distinguishes them from monospecific antibodies, creating unique therapeutic opportunities. Since their inception in the 1980s, BsAbs have progressed from theoretical concepts to clinically approved drugs, such as blinatumomab and amivantamab. Today, more than 20 commercialized platforms exist for BsAb development, with nine approved agents and over 100 in clinical trials as of 2024. Their pharmacology combines structural biology, pharmacokinetics, and pharmacodynamics, with advances in protein engineering enabling diverse formats tailored to clinical needs. As of February 2025, the field continues to grow, driven by deeper mechanistic understanding and the rising demand for personalized medicine.