Electron paramagnetic resonance spectroscopy (EPR) is an invaluable method for characterizing ligand environments and oxidation states of paramagnetic metal complexes. In this review we describe applications of this technique to understanding the often complicated mechanisms of metal-based anticancer compounds. EPR has been instrumental in unravelling this in many instances, providing insight into conformations upon dissolution, aqueous ligand exchange, pH effects, and redox processes. EPR studies have also characterized the pro-