Biofilm carriers play an important role in attached growth systems for wastewater treatment processes. This study systematically summarizes the traditional and novel biofilm carriers utilized in biofilm-based wastewater treatment technology. The advantages and disadvantages of traditional biofilm carriers are evaluated and discussed in light of basic property, biocompatibility and applicability. The characteristics, applications performance, and mechanism of novel carriers (including slow-release carriers, hydrophilic/electrophilic modified carriers, magnetic carriers and redox mediator carriers) in wastewater biological treatment were deeply analyzed. Slow release biofilm carriers are used to provide a solid substrate and electron donor for the growth of microorganisms and denitrification for anoxic and/or anaerobic bioreactors. Carriers with hydrophilic/electrophilic modified surface are applied for promoting biofilm formation. Magnetic materials-based carriers are employed to shorten the start-up time of bioreactor. Biofilm carriers acting as redox mediators are used to accelerate biotransformation of recalcitrant pollutants in industrial wastewater.