Consideration of soil as a living ecosystem offers the potential for innovative and sustainable solutions to geotechnical problems. This is a new paradigm for many in geotechnical engineering. Realising the potential of this paradigm requires a multidisciplinary approach that embraces biology and geochemistry to develop techniques for beneficial ground modification. This paper assesses the progress, opportunities, and challenges in this emerging field. Biomediated geochemical processes, which consist of a geochemical reaction regulated by subsurface microbiology, currently being explored include mineral precipitation, gas generation, biofilm formation and biopolymer generation. For each of these processes, subsurface microbial processes are employed to create an environment conducive to the desired geochemical reactions among the minerals, organic matter, pore fluids, and gases that constitute soil. Geotechnical applications currently being explored include cementation of sands to enhance bearing capacity and liquefaction resistance, sequestration of carbon, soil erosion control, groundwater flow control, and remediation of soil and groundwater impacted by metals and radionuclides. Challenges in biomediated ground modification include upscaling processes from the laboratory to the field, in situ monitoring of reactions, reaction products and properties, developing integrated biogeochemical and geotechnical models, management of treatment by-products, establishing the durability and longevity/reversibility of the process, and education of engineers and researchers.