A spectrum of materials has been explored as potential platforms for nanomedicine in the areas of drug delivery, imaging, and diagnostics/sensing. Depending upon the application required, the therapeutic compound being delivered, or the imaging agent being modified, certain nanoparticulate materials offer specific advantages that may uniquely enhance efficiency. Among the classes of particles being investigated, diamond-based platforms have emerged as promising vehicles for drug delivery and imaging following several recent studies that demonstrate their ability to enhance therapeutic efficacy, particularly for anthracyclines, mediate markedly improved magnetic resonance imaging contrast and photostable fluorescence, possess scalable processing parameters, and exhibit biocompatibility, among many other important attributes. More specifically, detonation NDs have faceted surfaces that can mediate potent interactions with surrounding water molecules or therapeutic compounds. This attribute can mitigate premature drug release to prevent major side effects such as myelosuppression, while water molecule recruitment can increase the relaxivity of covalently conjugated gadolinium. These properties of NDs and diamond-based devices will be discussed in this article, with a focus on therapeutic delivery in addition to insight on their use in imaging, devices, implants/coatings, and biocompatibility. Key areas of potential, where advances in biology and medicine can be realized through the continued development of this platform as well as requisite future studies, will also be highlighted.