Bioinert　poly(methyl　methacrylate)　(PMMA)　is　widely　employed　as　a　bone　cement　material　in　orthopedic　and　trauma　surgery　applications;　however,　its　susceptibility　to　bacterial　infection　and　bioinert　nature　limits　its　clinical　applications.　In　this　study,　we　developed　a　PMMA-based　bone　cement　incorporating　a　silver　nanoparticle-carbon　dots　(AgNP@CDs)　nanocomposite　(∼70nm)　at　concentrations　(2wt%)　with　a　Young’s　modulus　(324.74±7.08MPa)　to　simultaneously　combat　bacterial　infections,　minimize　cytotoxicity　and　support　tissue　regeneration.　The　CDs　stabilize　and　functionalize　AgNPs,　improving　their　dispersion　and　bioavailability　while　enabling　the　controlled　and　sustained　release　of　antimicrobial　ions　through　incorporation　with　bone　cement.　The　antibacterial　efficacy　of　the　composite　was　thoroughly　evaluated,　revealing　its　ability　to　disrupt　bacterial　cell　membranes,　generate　reactive　oxygen　species　and　inhibit　bacterial　growth.　These　mechanisms　collectively　contribute　to　a　significant　reduction　in　bacterial　growth　of　up　to　∼90%　in　both　in　vitro　and　in　vivo　studies.　The　incorporation　of　AgNP@CDs　ensures　sustained　antimicrobial　activity,　preventing　bacterial　colonization　by　controlling　the　leaching　of　Ag　ions.　Biocompatibility　assessments　showed　that　the　PMMA　composite　(PMMA@2Ag-CDs)　significantly　improved　cell　proliferation,　adhesion　and　migration　compared　with　pure　PMMA　bone　cement.　Additionally,　histological　analysis　revealed　that　the　PMMA　group　showed　a　fibrous　layer　thickness　of　699±35.32µm,　indicative　of　inflammation,　while　the　PMMA@2Ag-CDs　group　reduced　this　thickness　from　301.18±22.42µm　on　day　7　to　198.07±15.21µm　on　day　14,　significantly　decreasing　inflammation.　The　PMMA@2Ag-CDs　composite　demonstrated　better　tissue　integration,　with　organized　collagen　deposition　and　enhanced　angiogenesis,　indicating　more　efficient　tissue　regeneration.　The　reduced　inflammation　and　improved　tissue　remodeling　suggest　that　this　composite　promotes　a　more　favorable　tissue　regeneration　environment　and　minimizes　complications.　This　study　demonstrates　that　the　PMMA@2Ag-CDs　composite　offers　a　promising　solution　for　the　prevention　of　infections　and　mitigation　of　inflammatory　responses.　Functionalization　of　bone　cement　through　the　incorporation　of　Ag　nanoparticle-carbon　dot　nanocomposites　is　a　promising　strategy　with　potential　practical　applications　in　orthopedic　and　trauma　surgery.　©　The　Author(s)　2025.　Published　by　Oxford　University　Press.