Hydrogel-based wound dressings are one of the most promising materials in wound care, fulfilling important dressing requirements, including: (a) keeping the wound moist whilst absorbing extensive exudate, (b) adhesion-free coverage of sensitive underlying tissue, (c) pain reduction through cooling and (d) a potential for active intervention in the wound healing process. Although numerous hydrogel-based dressings are already on the market, new wound care treatment options are urgently required to address the growing number of severe, acute and chronic wounds experienced by today’s aging society. High cost, safety concerns surrounding the use of drugs and allogeneic/xenogeneic materials, and issues specific to hydrogels, such as lack of mechanical stability, are impeding clinical implementation of many novel approaches. To meet clinical needs, the development of new hydrogel wound dressings that overcome these drawbacks would be desirable. This review provides a broad overview of recent progress – commercial and scientific – in the field of bioactive hydrogel wound dressings. A variety of approaches to bioactive wound healing, such as bioactive dressing materials, use of antimicrobial agents, inclusion of biological signaling molecules like growth factors, and incorporation of seeded stem cells, are considered and critically evaluated.