In recent years, metal peroxide (MO
2
) such as CaO
2
has received more and more attention in cancer treatment. MO
2
is readily decompose to release metal ions and hydrogen peroxide in the acidic tumor microenvironment (TME), resulting metal ions overloading, decreased acidity and elevated oxidative stress in TME. All of these changes making MO
2
an excellent tumor therapeutic agent. Moreover, by combining MO
2
with photosensitizers, enzymes or Fenton reagents, MO
2
can assist and promote various tumor therapies such as photodynamic therapy and chemodynamic therapy. In this review, the synthesis and modification methods of MO
2
are introduced, and the representative studies of MO
2
-based tumor monotherapy and combination therapy are discussed in detail. Finally, the current challenges and prospects of MO
2
in the field of tumor therapy are emphasized to promote the development of MO
2
-based cancer treatment.