Nanomedicines have demonstrated significant potential in disease diagnosis and therapy, revolutionizing traditional drug development patterns. Recently, inspired by both natural and engineering principles, synthetic biology integrates the complexity of biological systems with the precision of engineering to design and create novel biological components, devices, and systems. This convergence of synthetic biology and nanomedicine has led to the emergence of a new concept: synthetic biological nanomedicine. Unlike traditional or biomimetic nanomedicines, synthetic biological nanomedicines are designed using gene engineering-based strategies. In this Perspective, the foundational concepts of synthetic biological nanomedicine are introduced and its relationship to, and differences from, traditional and biomimetic nanomedicine are explored. Drawing from synthetic biology, synthetic biological nanomedicine also incorporates two main approaches: top-down and bottom-up strategies. The latest advancements in the application of synthetic biology to nanomedicine are reviewed, these developments are categorized according to the aforementioned strategies, and a discussion of the potential advantages and challenges associated with utilizing synthetic biology in nanomedicine development is concluded.