Chemotherapy is the first choice for the majority of cancers, but severe side effects and drug resistance restrict the actual clinical efficacy. Carbazole alkaloids, mainly from the Rutaceae family, possess favorable donor ability, good planarity, rich photophysical properties, and excellent biocompatibility. Carbazole alkaloids could not only intercalate in DNA but could also inhibit telomerase and topoisomerase and regulate protein phosphorylation. Hence, carbazole alkaloids are useful in providing lead hits/candidates for the development of novel anticancer agents. This review summarizes the research progress made regarding the anticancer properties of carbazole alkaloids, covering articles published from January 2010 to June 2021.