Conventional Subtractive Manufacturing (CSM) remains a cornerstone in the production of biomedical implants, enabling the fabrication of precision-engineered components with complex geometries and stringent dimensional tolerances. Despite the rapid evolution of additive manufacturing, CSM techniques such as CNC machining, milling, turning, and grinding continue to offer superior mechanical integrity and surface finishes required for critical orthopaedic, dental, and spinal implants. This review paper aims to consolidate the contributions of various researchers in advancing CSM for biomedical applications, emphasising precision manufacturing, surface integrity, and post- processing functionalisation strategies. The paper critically examines the effects of cutting parameters, tool geometries, and coolant strategies on microstructural evolution, residual stress development, and surface topography of biomedical alloys such as titanium, cobalt-chromium, and magnesium. It further discusses post-machining surface modification techniques, including polishing, laser texturing, and coating, to enhance biocompatibility and osseointegration. Additionally, the review highlights emerging trends in sustainable machining, digital twin integration, and hybrid subtractive–additive approaches for implant manufacturing. By presenting these insights, this paper serves as a comprehensive reference for researchers and industry professionals, guiding future innovations while addressing current challenges in advancing CSM for biomedical implant development.