Paclitaxel (PTX) is a broad-spectrum alkaloid anticancer drug with high therapeutic efficacy. However, PTX has a very low water solubility and its metabolism demonstrates nonlinear pharmacokinetic characteristics, resulting in systemic adverse reactions in clinical applications. Many endeavors are devoted to develop new PTX preparations in response to these obstacles, and some are used in clinical phase of cancer treatment. In particular, highly specific medical intervention at nanoscale is an emerging research field focusing on nanoapproaches to solve clinical problems. In a perspective of nanomedicine, the recent covalent and noncovalent approaches toward PTX formulation on various substrates, as well as their advantages and disadvantages during preclinical researches and clinical applications are herein summarized. It is anticipated that nanotechnology-based drug delivery systems can further enhance therapeutic efficiencies of PTX, by reducing systemic side effects and alleviating severely negative effects on patients.