Shape-morphing smart medical devices constitute a current research trend and are bound to transform healthcare thanks to the improved interactions with the human body they enable. 4D printing technologies facilitate the development of such devices and start to provide innovative solutions like minimally invasive surgical tools and devices, ergonomic appliances and orthoses, evolutive implants and active in vitro biodevices, among others. Most studies so far, dealing with 4D printed biodevices, have been focused on smart polymeric materials and structures, whose biomechanical, biochemical and biological properties cannot always match those from shape-morphing and shape-memory alloys (SMAs). Considering several recent synergic breakthroughs in the additive manufacturing of smart alloys, this study presents 4D printing with SMAs for a new generation of medical devices, illustrated through case studies by our team. The more relevant strategies under research for enhancing the performance of 4D printed NiTi are illustrated and varied foreseen directions for achieving a sustainable and equitable impact in healthcare are discussed.