This review explores the transformative potential of Bacterial cellulose (BC) in an increasingly vital avenue of transdermal drug delivery systems (TDDS) for multi-scale therapeutic applications with patient-centric approach. In this review, we have not only highlighted the role of BC as the main matrix material for TDDS but emphasized the other possible role that BC can play in TDDS. For this purpose, we have delved into the avenues of the physico-chemical interactions that BC can offer in governing the incorporation of different length-scales of therapeutics as well as tuning their extent of loading. Furthermore, this review underscores BC's potential in developing need-specific drug release profiles and stimuli-responsive release platforms, enabling their application in TDDS for wound healing, pain management, and targeted delivery for chronic diseases. Apart from the existing literature, this review focuses on patient comfort, which is an often-overlooked aspect, and highlights how BC's unique physicochemical properties enhance user experience. Additionally, this review justifies the potential of BC in compliance with the other parameters of the TDDS, including shelf-life, design requirements, and evaluation strategies in ensuring their clinical translation and user acceptance. To harness BC's potential in the new era of personalized TDDS, this review also sheds light on the challenges of standardizing BC production processes with appropriate data disclosure, ensuring adhesion and anti-microbial actions, along with the integration of passive and active technologies.