Abstract: The β-type Ti-Nb-based shape memory alloys have garnered significant attention in biomedical research due to their exceptional cold and hot working properties, low elastic modulus, high corrosion resistance, excellent biocompatibility, and remarkable shape memory effect and superelasticity. However, the superelasticity strain of conventional β-type Ti-Nb-based shape memory alloys is much lower than that of commercially biomedical binary Ti-Ni shape memory alloys, which poses a significant challenge to their application in the biomedical field. To further promote the practical application of β-type Ti-Nb based shape memory alloys in the biomedical field, microstructure engineering and alloying have been adopted to enhance their superelasticity behavior. The present study provided an in-depth analysis of the intrinsic relationships between the current measures and microstructure, martensitic transformation behaviors, superelasticity, and the physical mechanisms underlying the improvement of superelasticity. Meanwhile, the mechanical properties, wear resistance, corrosion resistance and biocompatibility of biomedical β-Ti-Nb memory alloy were also reviewed. Finally, the present paper outlined the key and challenging problems that need to be addressed in future research on β-type Ti-Nb-based shape memory alloys.