Ultra-high molecular weight polyethylene (UHMWPE) fiber has emerged as a critical material advancing the development of minimally invasive medical devices, owing to its exceptional specific strength, outstanding wear resistance, and inherent bio-inertia. We systematically review the current application landscape of UHMWPE fibers in minimally invasive medicine, highlighting their broad use in orthopedic sutures and fixation systems, reinforcement layers for cardiovascular interventional devices, cables to drive surgical robots, and materials in frontier neural interfaces. These applications underscore the material’s core advantages across diverse scenarios. However, its broader clinical translation faces multiple challenges, including surface bio-inertia, long-term dynamic durability, difficulty in processing, and a lack of standardization. To address these challenges, this article delves into comprehensive strategies encompassing surface engineering, composite material development, structural optimization, and intelligent control algorithms. Looking forward, UHMWPE fibers are poised to evolve towards intelligence and functional integration. Through deep convergence with flexible electronics and data-driven research, coupled with the establishment of robust standardization systems, UHMWPE fibers are expected to play an even more pivotal role in the next generation of advanced minimally invasive medical devices, ultimately propelling the field towards greater precision and personalization.