Fermentation, a process traditionally known for the anaerobic conversion of sugar to carbon dioxide and alcohol by yeast, now refers to an industrial process of manufacturing a wide variety of metabolites and biomaterials by using microorganisms or mammalian cells in a controlled culture environment. Fermentation can be performed in batch mode, continuous mode or in a combinatory, fed-batch mode, depending on the product of interest. Fermentation technology has long been known for the production of various medically important products such as antibiotics, solvents such as ethanol, intermediary compounds such as citric acid, probiotics such as yoghurt etc. New generation fermentation products include anti-viral drugs, therapeutic recombinant proteins and DNA, and monoclonal antibodies. Apart from the drugs, fermentation is also used for the commercial production of materials required for the development of diagnostic kits, drug delivery vehicles and medical devices. Fermentation technology remains at the heart of rapidly growing biopharmaceutical industry today, which is expected to expand even more in the days ahead, in parallel with the progress in novel, targeted drug discovery.