Alginate hydrogels have appeared as a highly promising category of biocompatible medical devices that can be implanted, injected, or implemented on the body. They have gained significant interest in the domains of wound healing, drug delivery, and tissue engineering due to their structural resemblance to extracellular matrices of tissues and their versatility in performing multiple crucial functions. Numerous "smart" composite hydrogels that react to external stimuli have been designed by integrating responsive polymers and nanomaterials into alginate hydrogels as a matrix. Functionalization of alginate hydrogels with targeting moieties such as antibodies or peptides can facilitate drug delivery to specific cells or tissues. Alginate hydrogels are often modified to enhance their interaction with mammalian cells and/or alter their mechanical properties, despite their inherent biocompatibility. Instead of two-dimensional (2D) cell culture, alginate-based hydrogels can be used for three-dimensional (3D) in vitro models to better understand the in vitro mechanisms of drug delivery systems. As a result of recent advancements, alginate-based systems have expanded their applicability and are now accessible to a wider range of approaches. This chapter provides a concise summary of the preparation techniques, properties, and various in vitro and preclinical applications of alginate hydrogel as an ambitious drug carrier for biomedical and pharmaceutical applications.