Biodegradable porous silicon is under preclinical assessment for a range of drug delivery applications, and in this updated review, data is now available on more than 30 active pharmaceutical ingredients (API). Studies to date on oral, subcutaneous, intravenous, intravitreal, and intratumoral modes of delivery are covered. Sustained delivery of an increasing range of biological actives, like peptides and antibodies, is under evaluation, as are bioavailability enhancements for small hydrophobic APIs. Both the merits and existing challenges of this nanostructured carrier are raised.