Accelerator mass spectrometry (AMS) is an ultrasensitive measure for tracing i4C labeled molecules in vivo or detecting the biomarker for assessment of carcinogenesis. Basic principles, wide applications and new progresses of bio-14C-AMS have been presented. It is a state-of-the-art tool for measuring the adduction of biological molecules with xenobiotics, including carcinogens, drugs, agrochemicals, nicotine etc.. We have studied the genotoxicity and proteins adduction of smoking specific nicotine and its nitrosamine derivative NNK since 1994. The successful applications have proven the effectiveness of AMS in assessment of cancer risk, screening of drug toxicity and studies of nutrient uptake. In particular, AMS is characterized by measuring xenobiotics at very low dose levels relevant to human environmental exposure. It is sensitive and precise to an attomole (10-18 mole) of 14C per mg carbon. Although it has some shortcomings, undoubtedly, AMS possesses an evident merit of high sensitivity and will have widespread applications in the biomedical sciences.