Micropatterned polymer brushes are a revolutionary platform that has opened up unique biomedical application possibilities through spatial control of surface characteristics. Unlike traditional polymer-brush coatings that enable homogeneous surface modifications, micropatterned brushes allow the fabrication of heterogeneous surfaces by providing localized functionality for enhanced biological interactions. This review presents different lithography techniques followed by surface-initiated polymerization as advanced fabrication methods that are vital in creating such a modulated surface architecture. Despite remarkable achievements, issues of scalability and reproducibility of the created surfaces remain a core challenge toward their industrial utilization. By critically evaluating these methodologies and their integration with biomedical technologies, we have outlined the current limitations and potential breakthroughs required for the future deployment of micropatterned polymer brushes in healthcare, particularly in areas such as biosensing, drug delivery, and tissue engineering.