Tumor microparticles (T-MPs) are vesicles released from tumor cells when they receive apoptotic or stimuli signals. T-MPs, which contain some proteins, lipids and nucleic acids from tumor cells, contribute to the exchange of material, energy and information between cells. T-MPs contain both tumor antigens and innate immunostimulatory signals, making T-MPs as a new form of tumor vaccine. Meanwhile, T-MPs can be used as natural carriers to transport ‘‘cargoes’’, such as chemotherapy drugs, oncolytic viruses, nucleic acids, and metal nanoparticles to treat tumors. In addition, T-MPs enhance the effect of chemotherapy. This review introduces the application of T-MPs as vaccines, delivery systems and chemosensitizers in tumor prevention and treatment, with a focus on the mechanisms, clinical applications, and influencing factors of drug-loaded T-MPs in tumor treatment.