As a new drug delivery platform, microneedles offer advantages such as painless, minimally invasive administration and rapid high-dose drug delivery. They can efficiently and precisely deliver drugs to target sites, playing a crucial role in enhancing therapeutic efficacy and reducing toxicity. Microneedle technology has been applied to the delivery of anticancer drugs, and when combined with photothermal and photodynamic therapies, immunotherapy, and other approaches, it provides new solutions and perspectives for anticancer treatment. Additionally, microneedle technology is utilized for drug monitoring and diagnostics. By detecting tumor-specific signaling factors in bodily fluids like interstitial fluid, it enables predictive analysis, aiding in early treatment and prevention. Consequently, microneedle technology holds promise for delivering efficient, precise, and safe personalized treatment plans for cancer patients in the future, injecting new momentum into the fight against cancer.