An overview is presented of the use of hydrogel composites as biomaterials. These range from laminates or coatings (in which a homogeneous hydrogel is used in conjunction with a more mechanically stable substrate), through blends of hydrogels with synthetic hydrophobic polymers, to the use of two-component systems in which water enhances the compatibility of two structurally different polymers. Although synthetic hydrogels provide an ideal basis for materials of these types, naturally occurring hydrophilic polymers with their unique properties have a major contribution to make. It is in the clinical and patent literature, rather than journals dealing with polymers per se, that the vast majority of examples of the use of hydrogel composites are found. This review collects and comments on examples based on synthetic developments in this field during the last decade, particularly in relation to the development of wound dressings and implant materials.