Over the past decade numerous drug delivery systems have been developed to improve the treatment of different diseases and disorders. Albumin has been widely studied as a protein carrier for drug delivery, a stable endogenous protein; albumin has been employed as a non-immunogenic delivery carrier and extensively researched in various disease therapies. To provide the prospective for future research, this review summarizes the application of albumin as drug or imaging agent carriers for treating different diseases and disorders such as diabetes, hepatitis C and rheumatoid arthritis, Cancer, Tumor, Cardiovascular disorders, Hypovolemia, Hypoaluminea and potential future directions. There are three major types of albumin-based carrier systems including albumin drug conjugates, albumin particles and genetic infusion albumin. Their imaging or therapeutic effects have been proved in clinic or preclinical studies.