[Abstract] Immune cell-mediated delivery system employs immune cells as carriers to deliver therapeutic drugs to specific lesion sites by leveraging the innate chemotaxis of these cells. Due to its excellent biocompatibility, low immunogenicity, tissue-specific homing, and ability to cross biological barriers, this approach has emerged as an important strategy for drug delivery and disease treatment. This article systematically discusses the drug delivery strategies of immune cells, the biological characteristics, advantages, and disadvantages of using monocytes, neutrophils, mesenchymal stem cells, and dendritic cells as carrier cells, as well as the latest research progresses on their application in tumor treatment. This review provides valuable insights for further studies on immune cell-mediated drug delivery systems and their clinical transformation.