Research has clarified the properties required for polymers that resist bacterial colonisation for use in medical devices. The increase in antibiotic-resistant microorganisms has prompted interest in the use of silver as an antimicrobial agent. Silver-based polymers can protect the inner and outer surfaces of devices against the attachment of microorganisms. Thus, this review focuses on the mechanisms of various silver forms as antimicrobial agents against different microorganisms and biofilms as well as the dissociation of silver ions and the resulting reduction in antimicrobial efficacy for medical devices. This work suggests that the characteristics of released silver ions depend on the nature of the silver antimicrobial used and the polymer matrix. In addition, the elementary silver, silver zeolite and silver nanoparticles, used in polymers or as coatings could be used as antimicrobial biomaterials for a variety of promising applications.