Matter at the atomic-scale is inherently governed by the laws of quantum mechanics. This makes charges and spins confined to individual atoms—and interactions among them—an invaluable resource for fundamental research and quantum technologies alike. However, harnessing the inherent ‘quantumness’ of atomic-scale objects requires that they can be precisely engineered and addressed at the individual atomic level. Since its invention in the 1980s, scanning tunnelling microscopy (STM) has repeatedly demonstrated the unrivalled ability to not only resolve but manipulate matter at atomic length scales. Over the past decades, this has enabled the design and investigation of bottom-up tailored nanostructures as reliable and reproducible platforms to study designer quantum physics and chemistry, band topology, and collective phenomena. The vast range of STM-based techniques and modes of operation, as well as their combination with electromagnetic fields from the infrared to microwave spectral range, has even allowed for the precise control of individual charge and spin degrees of freedom. This roadmap reviews the most recent developments in the field of atomically-engineered quantum platforms and explores their potential in future fundamental research and quantum technologies.