To date, cancer remains one of the most lethal diseases that threatens public safety. High concentrations of reactive oxygen species (ROS) can directly induce cell apoptosis and necrosis, so it is an effective strategy to increase the ROS content in tumor cells. In recent years, ROS-mediated cancer therapy has been extensively studied. As an important transition-metal element, Mn plays a key role in biological processes. With the rapid development of nanotechnology and oncology, Mn-based materials have been widely used in ROS-mediated cancer therapy as an ideal integrated nanoplatform. This review first summarizes the research progress of Mn-based nanomaterials (NMs), including their structures and main synthesis methods. Then the biomedical applications of Mn-based NMs for ROS-mediated cancer therapy are brought into focus. Finally, the challenges and development directions of Mn-based NMs used for ROS-mediated cancer therapy are rationally analyzed, which are necessary for their future clinical translation.