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There has been a great interest in evaluating the potential of severe plastic deformation (SPD) to improve the performance of magnesium for biological applications. However, different properties and trends, including some contradictions, have been reported. The present study critically reviews the structural features, mechanical properties, corrosion behavior and biological response of magnesium and its alloys processed by SPD, with an emphasis on equal-channel angular pressing (ECAP) and high-pressure torsion (HPT). The unique mechanism of grain refinement in magnesium processed via ECAP causes a large scatter in the final structure, and these microstructural differences can affect the properties and produce difficulties in establishing trends. However, the recent advances in ECAP processing and the increased availability of data from samples produced via HPT clarify that grain refinement can indeed improve the mechanical properties and corrosion resistance without compromising the biological response. It is shown that processing via SPD has great potential for improving the performance of magnesium for biological applications.