As a novel two-dimensional (2D) nanosheet (NS), MXene has attracted attention in antibacterial applications due to its excellent high surface area, remarkable hydrophilicity, strong flexibility, and excellent antibacterial properties. This review intends to provide valuable insight into the further development of antibacterial MXenes and their composite materials. In this paper, we review the antibacterial mechanisms of MXenes and their composite materials and summarize the research progress of antibacterial finishing fabrics, fibers and dressings based on MXene NSs. Due to the rich oxygen-containing groups, 2D MXene NSs and its composites exhibited significant antibacterial activity against Escherichia coli, Staphylococcus aureus, and Bacillus subtilis so they have been widely used in antibacterial textiles including finishing fabrics, fibers, and dressings. 2D MXene NSs have showed some antibacterial properties based on cell experiments or blood tests. The antibacterial mechanisms mainly include physical sterilization and chemical oxidative stress sterilization. The future direction of antibacterial textiles based on MXenes was proposed.