Abstract The potential of polytetrafluoroethylene (PTFE) products as surgical dressings is considerable, yet their absence of antibacterial properties substantially restricts their medical applications. To enhance the utility of PTFE in the medical sector, this research loaded nano zinc oxide (ZnO) particles into the PTFE filament matrix through a wet spinning process. This approach successfully yielded PTFE/ZnO composite filaments with antibacterial properties. The characterization results of the filaments show that when the mass ratio of PTFE to ZnO is 8:1, the filament has the best mechanical performance with a tensile strength of 6.78 MPa and an elongation at break of 274.46%. At the same time, composite antibacterial filaments under different process conditions show excellent antibacterial effects against Escherichia coli ( E. coli ) and Staphylococcus aureus ( S. aureus ), with an antibacterial rate of over 99%. The excellent mechanical properties ensure the ability to further process single filaments, which can be woven into fabrics, textiles, and various other products. Therefore, the composite antibacterial filaments with excellent comprehensive performance prepared in this study are expected to be applied in the field of medical fabrics. Highlights Provide new solution ideas for functional PTFE composite filaments preparation. The prepared PTFE/ZnO composite filament has good acid and alkali resistance as well as excellent antibacterial properties, which is expected to broaden the application field of PTFE filaments.