Emergent RNA technologies employ sequence and structural information to perform a diversity of biological functions. Synthetic RNA molecules have been developed for a wide array of applications, including genetic regulation, environmental sensing, and diagnostics devices. Recent advances in chemical synthesis and computational design of RNA have enhanced our ability to program novel functions and expand upon current biomedical applications for therapeutics and diagnostics. In this review, we highlight recent advances in synthetic RNA devices that have been engineered for biomedical systems, while addressing the current limitations and challenges of translating these engineered functional RNAs to clinical applications.