Background <p>Carrier-free nanomedicine refers to nanoparticle systems composed solely of therapeutic agents without additional carrier materials. These systems typically rely on the self-assembly of drugs, peptides, or genetic materials into nanoscale structures that increase therapeutic efficacy and reduce systemic toxicity. As this approach eliminates the need for artificial carriers, it offers simplified formulations and improved drug loading, making it an attractive strategy in nanomedicine development.</p> Area covered <p>This review outlines the major classes of carrier-free nanomedicines, including those based on small molecules, peptide conjugates, and genetic materials. Recent advances in the design and functionalization of these systems, along with representative examples of clinically relevant formulations, are highlighted. Key challenges such as reduced bioactivity of the active core and complex synthesis methods are also discussed.</p> Expert opinion <p>Despite certain limitations, such as inconsistent bioactivity of self-assembled structures, limited control over in vivo stability, and challenges in large-scale reproducibility, carrier-free nanomedicines present notable advantages in terms of drug efficacy, safety, manufacturing scalability, and cost-effectiveness. Continued innovation in this field is expected to drive the clinical translation of nanomedicine, especially in oncology and precision therapy. Future research should focus on optimizing assembly mechanisms and overcoming current barriers to bioavailability and stability. With these improvements, carrier-free nanomedicines are expected to make significant clinical advances in the near future.</p>