Abstract: Chitosan (CS), a natural cationic linear polysaccharide, exhibits broad application prospects in biomedicine and wastewater treatment due to its excellent antibacterial activity, biocompatibility, and biodegradability. However, the dissolution and spinnability limitations caused by its molecular structure characteristics remain a key constraint for material applications. This work systematically investigated CS-based fibers. The effects of diverse solvent systems—including acidic solvents, organic solvents, ionic liquids, and alkali/urea solutions—on the solubility and spinnability of CS were reviewed. CS was blended with synthetic polymers like polyvinyl alcohol and polyethylene oxide, or natural polymers such as cellulose and alginate. The blends were processed via electrospinning or wet-spinning techniques. Fiber materials combining exceptional mechanical properties, antibacterial functionality, and biocompatibility were successfully prepared. Furthermore, the antibacterial mechanisms and functional modification strategies were summarized. The findings demonstrate that this research provides a theoretical foundation and technical references for the future development and application of CS-based fiber materials.