At present, many studies have emphasized the importance of tsRNAs in tumors and revealed their important role in the biological processes of tumor cell proliferation, apoptosis, and metastasis. By systematically analyzing the production and biological function of tsRNAs in various tumors, we elucidate its mechanism of action in tumor occurrence and progression, and discuss their potential as biomarkers and therapeutic targets, as well as their application prospects in tumor precision medicine. We believe our review can provide valuable insights and direction for innovation in cancer research and treatment strategies. (By Professor Ming Lei, https://jmg.bmj.com/content/early/2024/12/31/jmg-2024-110437 )