Irreversible electroporation (IRE) is a nonthermal ablation technique that uses high-voltage electrical pulses to induce permanent nanopores in cell membranes, leading to apoptosis while preserving the extracellular matrix and adjacent critical structures. Its unique mechanism of action makes it particularly advantageous for tumors located near heat-sensitive tissues such as blood vessels, bile ducts, nerves, and the urinary tract, where conventional thermal techniques are contraindicated. Originally developed for soft tissue ablation, IRE has gained traction in the treatment of prostate, liver, and pancreatic cancers, with expanding evidence supporting its safety and efficacy. In prostate cancer, IRE offers the potential to reduce treatment-related morbidity by preserving continence and erectile function. In liver and pancreatic tumors, it has shown promising outcomes for lesions unsuitable for resection or thermal ablation, particularly in the presence of the heat-sink effect or proximity to vital structures. Data from both prospective studies and registries report encouraging local control and survival outcomes in these settings. Emerging applications include musculoskeletal tumors and desmoid tumors, with preclinical and early clinical evidence suggesting that IRE maintains bone integrity and may stimulate tissue regeneration. Despite its growing use, IRE remains an investigational modality in several fields, with ongoing clinical trials aiming to define its role more precisely. Overall, IRE represents a versatile, structurally preserving ablation option with broad potential across oncologic indications. Further research, including randomized controlled trials and technical standardization, is essential to fully integrate IRE into routine clinical practice.