The article reviews reactive extrusion and its application for the synthesis of polyurethanes for biomedical applications. Reactive extrusion is gaining increased popularity in the synthesis of polyurethanes due to flexibility, ease of process, control of exotherm reaction and applicability to both industrial and biomedical applications. Reactive extrusion processing techniques and various options to prepare cross-linked polyurethanes during the reactive extrusion synthesis are described. A brief introduction of polyurethane chemistry and properties is provided to understand the chemical processes involved in polyurethanes synthesis to help explain how reactive extrusion can be used to control those processes to prepare materials with optimum performance characteristics.</p