Enzyme-based biocatalysis has become an advanced approach that has been demonstrated to be more sustainable. It is considered one of the most economical, efficient, and eco-friendly processes for the production of active pharmaceutical intermediates and pharmaceuticals. The basic principle of biocatalysts in green chemistry is to use enzymes instead of chemical catalysts to target molecules that support the sustainable green chemistry industry. The biocatalyst performs a biocatalytic cascade reaction, in which each chemical step is catalyzed by an enzyme. The mechanism involved in biocatalysis is to utilize biological macromolecules to catalyze small molecular transformations. This review presents the principles, mechanisms, and applications of biocatalysis, with a focus on its role as a transformative technology in making industrial processes more sustainable, as well as its potential to develop revolutionary green innovations in the future. This chapter highlights the history of biocatalysis and recent developments in the production of advanced therapeutic drugs in the pharmaceutical industry, as well as current limitations in technology, cost, and sustainability.