Antifouling polymers are materials that can resist nonspecific interactions with cells, proteins, and other biomolecules. Typically, they are hydrophilic polymers with polar or charged moieties that are capable of strong nonbonding interactions with water molecules. This propensity to bind water generates a surface hydration layer that reduces nonspecific interactions with other molecules and is paramount to the antifouling behavior. This property is especially useful for nanoscale applications such as nanomedicine and surface modifications at the molecular level. In nanomedicine, antifouling polymers such as poly(ethylene glycol) and its alternatives play a key role in shielding drug molecules and therapeutic proteins/genes from the immune system within nanoassemblies, thereby enabling effective delivery to target tissues. For coatings, antifouling polymers help to prevent adhesion of cells and molecules to surfaces and are thus valued in marine and biomedical device applications. In this Review, we survey recent advances in antifouling polymers in the context of nanomedicine and coatings, while shining the spotlight on the major polymer classes such as PEG, polyzwitterions, poly(oxazoline)s, and other nonionic hydrophilic polymers.