The increasing incidence of antibiotic resistance, coupled with a growing prevalence of cancer and allergic conditions in an aging population, has forced clinical research to explore alternative therapeutic and prophylactic avenues. One such approach involves the use of probiotics: beneficial bacterial cultures, which, when administered as a part of the daily dietary intake, reduce the incidence and severity of acute and chronic infection, facilitate prevention and reduced recurrence of certain cancers and lower the incidence of several atopic conditions. Herein, we review the most recent advances in the emerging area of patho-biotechnology in the context of improving probiotic production, delivery and clinical efficacy, in addition to the emerging area of 'designer probiotics'- strains specifically tailored to target certain pathogens and/or toxins in vivo.