This review summarizes the design principles and key features of programmable hydrogels that respond to multiple stimuli. It then delves into the cutting‐edge mechanisms of self‐executing systems, highlighting their role as the cornerstone of next‐generation programmable hydrogels (NGPHs). Finally, by addressing critical challenges in complexity and translation, the review looks to the future of NGPHs, emphasizing their evolution toward dynamic closed‐loop control, biomimetic intelligence, and successful clinical integration. Abstract Programmable hydrogels are an emerging class of intelligent materials engineered to respond precisely to specific stimuli, offering tailored functionalities with significant potential for biomedical applications, including drug delivery, tissue engineering, and wound healing. This review comprehensively explores various programmable hydrogels responsive to diverse triggers, including temperature, gene expression, color, shape, and mechanical force. The design and fabrication methods underlying these systems are detailed, highlighting the roles of crosslinkers, adhesion groups, and photosensitive functional groups. Furthermore, the key physical, chemical, and biological properties that govern the performance and functionality of hydrogels are analyzed. The review further examines the mechanisms and recent advancements in self‐executing hydrogels, such as self‐activated, self‐oxygenated, self‐expandable, and self‐powered systems, demonstrating how these innovative designs drive the development of next‐generation programmable hydrogels. The main challenges in hydrogel design, including complexity, reproducibility, and clinical translation, are also addressed. Finally, a perspective on future research directions, highlighting the integration of the latest technologies to realize programmable hydrogels with dynamic closed‐loop responsiveness, bionic synergy, and robust clinical applicability, is offered. This review summarizes the design principles and key features of programmable hydrogels that respond to multiple stimuli. It then delves into the cutting-edge mechanisms of self-executing systems, highlighting their role as the cornerstone of next-generation programmable hydrogels (NGPHs). Finally, by addressing critical challenges in complexity and translation, the review looks to the future of NGPHs, emphasizing their evolution toward dynamic closed-loop control, biomimetic intelligence, and successful clinical integration. Abstract Programmable hydrogels are an emerging class of intelligent materials engineered to respond precisely to specific stimuli, offering tailored functionalities with significant potential for biomedical applications, including drug delivery, tissue engineering, and wound healing. This review comprehensively explores various programmable hydrogels responsive to diverse triggers, including temperature, gene expression, color, shape, and mechanical force. The design and fabrication methods underlying these systems are detailed, highlighting the roles of crosslinkers, adhesion groups, and photosensitive functional groups. Furthermore, the key physical, chemical, and biological properties that govern the performance and functionality of hydrogels are analyzed. The review further examines the mechanisms and recent advancements in self-executing hydrogels, such as self-activated, self-oxygenated, self-expandable, and self-powered systems, demonstrating how these innovative designs drive the development of next-generation programmable hydrogels. The main challenges in hydrogel design, including complexity, reproducibility, and clinical translation, are also addressed. Finally, a perspective on future research directions, highlighting the integration of the latest technologies to realize programmable hydrogels with dynamic closed-loop responsiveness, bionic synergy, and robust clinical applicability, is offered. Advanced Science, EarlyView.