A method provided for the deposition of nanostructured ZnO on cotton fabric to introduce antibacterial functionality was presented in this article. This strategy enabled fabric to be coated with inorganic-based functional materials through in situ synthesis of nanoparticles using ultrasonic irradiation. The amino-terminated silicon sol (AEAPTS) was employed to generate nanostructured ZnO, and the mechanism of the ultrasound-assisted coating was proposed. Antibacterial activities, UV protection and other properties of ZnO-loaded cotton characterized by SEM, FTIR, XRD and TGA were investigated. The results indicated that ZnO-loaded cotton exhibited excellent UV protective property, efficient antibacterial activities, well water-resistant effect, together with moderate cytotoxicity against L929 and lower tensile strength. The developed method provides not only a facile way for in situ synthesis of ZnO on textile but also the production of antibacterial materials for healthcare applications.