Bacterial resistance to antibiotics has become a widespread concern, and poses serious environmental and global health problems. Lots of studies have demonstrated that engineered nanoparticles (NPs) can significantly affect bacterial antibiotic resistance; however, whether NPs promote or inhibit antibiotic resistance remains a complex and well-debated issue. This will constrain environmental antibiotic resistance gene contamination and clinical bacterial resistance problems, resulting in unclear and poorly targeted treatment efficacy. To better understand the relationship between NPs and antibiotic resistance, this review systematically summarizes and reanalyzes published data on the effect of NPs on bacterial antibiotic resistance and related mechanisms. The effects of intrinsic properties of NPs, such as size, concentration, functional groups, and extrinsic properties of NPs on the development of antibiotic resistance were dissected. This review will provide a better understanding of the effects of increasingly released NPs in different environments on bacterial resistance and underlines the direction for employing NPs to control the dissemination of antibiotic resistance genes in the environment. Next, how NPs affect intracellular and extracellular antibiotic resistance needs in-depth exploration. Besides, alternative treatments of NPs and antibiotics in therapy will be a future trend for combating antibiotic resistance, and the follow-up emphasis should determine their dose effects and potential mechanism. This study will expand our understanding of the biosafety of nanomaterials and provides a theoretical reference to guide the proper application of nanomaterials or technologies to environmental pollution control and clinical treatment.