Platelets have recently emerged as a versatile, biocompatible platform for antitumor therapy due to their innate tumor-homing capacity, ability to circulate systemically while loaded with therapeutic compounds, and their inherent ability to interact with the tumor microenvironment. Tumors naturally exploit platelets to promote immune evasion, metastasis, and microenvironment remodeling, making them an ideal vehicle for targeted therapeutic intervention in the treatment of cancer. By leveraging their role in tumorigenesis and maintenance, platelets can be engineered or loaded with chemotherapeutics, immunomodulators, or genetic material to enhance tumor-specific drug delivery while minimizing systemic toxicity. Diverse strategies, including passive drug loading, active loading, encapsulation, and hybrid platelet/synthetic systems, have demonstrated improved drug loading/retention and therapeutic efficacy in preclinical studies. Additionally, platelet surface molecules facilitate precise tumor localization, overcoming challenges of other nontargeted systemic dosing strategies. Ongoing advances in platelet bioengineering and nanotechnology continue to refine these drug delivery systems, though challenges such as platelet activation, storage limitations, and regulatory hurdles must be addressed for clinical translation. These innovations hold great promise for safer and more effective cancer therapies.