This research work presents the synthesis of ZnO nanopellets (ZNPs) by low temperature hydrothermal approach and evaluation of their antibacterial activity, cytotoxicity in vitro and in vivo. Structural and morphological studies conducted on the sample reveal hexagonal ZNPs in the size range of 250–500 nm. Surface area measurements showed high porosity of the sample compared to conventional ZnO nanoparticles. Antimicrobial studies revealed their bactericidal nature against both Gram-negative and Gram-positive bacteria. Furthermore, to better understand the parameters that affect the interactions between our ZNPs and mammalian cells, and thus their biocompatibility, we have examined the impact of cell culture conditions as well as of material properties on cytotoxicity by DPPH, blood hemolysis and MTT assay. The results showed good antioxidant capacity and biocompatibility of ZNPs at higher concentrations. MTT assay revealed the anticancer activity of ZNPs against prostate and breast cancer cell lines. Acute toxicity tests on Swiss albino mice showed no evident toxicity over a 14 days period.