Localized cancer treatment is one of the most effective strategies in clinical destruction of solid tumors at early stages as it can minimize the side effects of cancer therapeutics. Electrospun nanofibers have been demonstrated as a promising implantable platform in localized cancer treatment, enabling the on-site delivery of therapeutic components and minimizing side effects to normal tissues. This Review discusses the recent cutting-edge research with regard to electrospun nanofibers used for various therapeutic approaches, including gene therapy, chemotherapy, photodynamic therapy, thermal therapy, and combination therapy, in enhancing localized cancer treatment. Furthermore, it extensively analyzes the current challenges and potential breakthroughs in utilizing this novel platform for clinical transition in localized cancer treatment.