As a unique tubular nanoclay, halloysite nanotubes (HNTs) have recently attracted significant research attention. The HNTs have outer diameters of ∼50 nm, inner lumens of ∼20 nm and are 200–1000 nm long. They are biocompatible nanomaterials and widely available in nature, which makes them good candidates for application in biomedicine. Compared with other types of nanoparticles such as polymer nanoparticles and carbon nanotubes, the drawbacks associated with HNTs include brittleness, difficulty with fabrication, low fracture strength, high density and inadequate biocompatibility. Preparation of polysaccharide-HNT composites offer a means to overcome these shortcomings. Halloysite nanotubes can be incorporated easily into polysaccharides via solution mixing, such as with chitosan (CS), sodium alginate, cellulose, pectin and amylose, for forming composite films, porous scaffolds or hydrogels. The interfacial interactions, such as electrostatic attraction and hydrogen bonding, between HNTs and the polysaccharides are critical for improvement of the properties. Morphology results show that HNTs are dispersed uniformly in the composites. The mechanical strength and Young's modulus of the composites in both the dry and wet states are enhanced by HNTs and the HNTs can also increase the storage modulus, glass-transition temperature and thermal stability of the composites. Cytocompatibility results demonstrate that the polysaccharide-HNT composites have low cytotoxicity even for HNT loading >80%. Therefore, the polysaccharide-HNT composites show great potential for biomedical applications, e.g. as tissue engineering scaffold materials, wound-dressing materials, drug-delivery carriers, and cell-isolation surfaces.