In this review, the emerging roles of group IV nanoparticles including silicon, diamond, silicon carbide, and germanium are summarized and discussed from the perspective of biologists, engineers, and medical practitioners. The synthesis, properties, and biological applications of these new nanomaterials have attracted great interest in the past few years. They have gradually evolved into promising biomaterials due to their innate biocompatibility; toxic ions are not released when they are used in vitro or in vivo, and their wide fluorescence spectral regions span the near-infrared, visible, and near-ultraviolet ranges. Additionally, they generally have good resistance against photobleaching and have lifetimes on the order of nanoseconds to microseconds, which are suitable for bioimaging. Some of the materials possess unique mechanical, chemical, or physical properties, such as ultrachemical and thermal stability, high hardness, high photostability, and no blinking. Recent data have revealed the superiority of these nanoparticles in biological imaging and drug delivery.