High-intensity focused ultrasound (HIFU) and histotripsy are emerging soundwave-based modalities for noninvasive tumor ablation. HIFU employs thermal energy to induce coagulative necrosis, while histotripsy utilizes mechanical cavitation to disrupt tumor tissues. These technologies offer the potential for precise, targeted tumor destruction with minimal damage to surrounding structures, positioning them as attractive alternatives to conventional surgical and ablative techniques. While HIFU has established clinical applications, particularly in prostate, liver, and uterine tumors, histotripsy is gaining attention for its unique nonthermal approach and potential synergy with immunotherapy. Despite promising outcomes in preclinical and early clinical studies, challenges remain, including technical limitations related to tissue characteristics, anatomical constraints, and the need for standardized treatment protocols. This chapter reviews the current evidence, technological advancements, and clinical applications of HIFU and histotripsy, highlighting their potential integration with immunotherapy to enhance systemic antitumor responses. Further research and clinical trials are warranted to validate these techniques and establish their role in modern interventional oncology.