Mechanical energy, a ubiquitous renewable resource, can be effectively harnessed via piezocatalysis to convert physical stimuli into chemical energy for sterilization. As a promising green technology, piezocatalysis employs external mechanical force to physically disrupt bacterial membranes while simultaneously triggering redox reactions to generate bactericidal reactive oxygen species (ROS). Recent advances highlight the superior performance and broad applicability of this technology in the antibacterial domain. This review systematically elucidates the antibacterial mechanisms of piezocatalysis, followed by a comprehensive survey of prevalent piezoelectric biomaterials (e.g., amino acids, cellulose, proteins) and their synthesis strategies. Furthermore, specific applications of these bio-piezoelectric composites in sterilization are consolidated. Finally, we critically assess the primary challenges and outline future developmental trajectories, offering a prospective pathway for next-generation eco-friendly disinfection strategies.