► Carboxymethyl chitosan, a multi functional polymer derivative of chitosan. ► Synthesis characterization and physiochemical properties of carboxymethyl chitosan. ► Carboxymethyl chitosan-based systems for biomedical applications. ► Application in drug delivery, wound healing, tissue engineering, and gene therapy. This review outlines the recent developments on carboxymethyl chitosan-based bio-medical applications. Carboxymethyl chitosan, a water soluble derivative of chitosan, with enhanced biological and physicochemical properties compared to chitosan, has emerged as a promising candidate for different biomedical applications. Introducing small chemical groups like carboxymethyl to the chitosan structure can drastically increase the solubility of chitosan at neutral and alkaline pH values without affecting their characteristic properties. Due to improved biocompatibility, high moisture retention ability more viscosity and enhanced antimicrobial property of carboxymethyl chitosan than chitosan makes it promising candidate for hydrogels and wound healing applications. The biodegradability and biocompatibility of carboxymethyl chitosan has significant interest with application as biomaterial for tissue engineering. Apart from this, the easy of carboxymethyl chitosan can be easily processed into nanoparticles so it has shown promise for drug delivery, bioimaging, biosensors and gene therapy applications. The contribution of carboxymethyl chitosan to green chemistry in the recent years has also been given in detail. This review will focus on preparative methods and physicochemical and biological properties of carboxymethyl chitosan with particular emphasis on biomedical and pharmaceutical applications of this derivative of chitosan.