Abstract: Valvular Heart Disease (VHD), including stenosis and regurgitation, is a significant contributor to global cardiovascular morbidity. Current prosthetic solutions mechanical and bioprosthetic heart valves each present major limitation. Mechanical valves require lifelong anticoagulation due to thrombogenicity, while bioprosthetic valves suffer from structural degeneration and limited durability. Polymeric Heart Valves (PHVs) have emerged as promising alternatives, aiming to integrate the mechanical resilience of synthetic materials with the biocompatibility and hemodynamic performance of natural valves. Recent studies have explored advanced polymers such as Polyhedral Oligomeric Silsesquioxane–Polycarbonate–Urea–Urethane (POSS-PCU), Silicone–Polyurethane Urea (SiPUU), and nanocomposites like Polyvinyl Alcohol (PVA) and SIBS for their enhanced thromboresistance, calcification resistance, and long-term mechanical durability. Complementary to material innovation, fabrication methods such as 3D printing, Melt Electrospinning Writing (MEW), and Focused Rotary Jet Spinning (FRJS) offer patient-specific designs and microstructural control. This review systematically compares traditional and next-generation prostheses, examines mechanical and biological performance, and discusses critical design challenges including porosity, thrombogenicity, and leaflet calcification. Finite Element Analysis (FEA) and Computational Fluid Dynamics (CFD) are highlighted for optimizing design and simulating physiological conditions. By presenting recent preclinical progress and manufacturing strategies, this review outlines a translational roadmap toward clinically viable, biomimetic polymeric heart valves capable of addressing the needs of both adult and pediatric patients. Compared to traditional bioprosthetic tissues, advanced polymers offer better resistance to calcification, reduced thrombogenicity, and tunable mechanical properties.