Wound healing is a precisely orchestrated cascade involving coordinated interactions among immune cells, cytokines, growth factors, and extracellular matrix (ECM). Although acute wounds heal through orderly phases, infected and chronic wounds exhibit dysregulation with persistent inflammation, impaired immune resolution, and compromised regeneration. Conventional dressings provide passive barrier functions but limited therapeutic intervention. Immunomodulatory hydrogels represent sophisticated platforms that actively reprogram the wound immune microenvironment. These three-dimensional hydrophilic networks deliver bioactive agents, modulate immune responses, provide antimicrobial protection, and mimic native ECM. By controlling inflammation, promoting macrophage polarization toward pro-regenerative phenotypes, and stimulating angiogenesis and re-epithelialization, these materials address fundamental healing barriers. In infected wounds, they integrate antimicrobial and biofilm-disruptive mechanisms while preserving immune homeostasis. In non-infected lesions, they facilitate inflammatory resolution and promote regenerative repair. This review critically examines immunomodulatory hydrogel design, mechanisms, preclinical evidence, clinical translation, and future directions.