Needles are commonly used in medical procedures. However, current needle designs have some disadvantages. Therefore, a new generation of hypodermic needles and microneedle patches drawing inspiration from mechanisms found in nature (i.e. bioinspiration) is being developed. In this systematic review, 80 articles were retrieved from Scopus, Web of Science, and PubMed and classified based on the strategies for needle-tissue interaction and propulsion of the needle. The needle-tissue interaction was modified to reduce grip for smooth needle insertion or enlarge grip to resist needle retraction. The reduction of grip can be achieved passively through form modification and actively through translation and rotation of the needle. To enlarge grip, interlocking with the tissue, sucking the tissue, and adhering to the tissue were identified as strategies. Needle propelling was modified to ensure stable needle insertion, either through external (i.e. applied to the prepuncturing movement of the needle) or internal (i.e. applied to the postpuncturing movement of the needle) strategies. External strategies include free-hand and guided needle insertion, while friction manipulation of the tissue was found to be an internal strategy. Most needles appear to be using friction reduction strategies and are inserted using a free-hand technique. Furthermore, most needle designs were inspired by insects, specifically parasitoid wasps, honeybees, and mosquitoes. The presented overview and description of the different bioinspired interaction and propulsion strategies provide insight into the current state of bioinspired needles and offer opportunities for medical instrument designers to create a new generation of bioinspired needles.