The control of microbial infections is a very important issue in modern society. In general there are two ways to stop microbes from infecting humans or deteriorating materials—disinfection and antimicrobial surfaces. The first is usually realized by disinfectants, which are a considerable environmental pollution problem and also support the development of resistant microbial strains. Antimicrobial surfaces are usually designed by impregnation of materials with biocides that are released into the surroundings whereupon microbes are killed. Antimicrobial polymers are the up and coming new class of disinfectants, which can be used even as an alternative to antibiotics in some cases. Interestingly, antimicrobial polymers can be tethered to surfaces without losing their biological activity, which enables the design of surfaces that kill microbes without releasing biocides. The present review considers the working mechanisms of antimicrobial polymers and of contact-active antimicrobial surfaces based on examples of recent research as well as on multifunctional antimicrobial materials.