Abstract: Radiation enteritis (RE) is a common complication following radiotherapy for abdominal and pelvic malignancies. Currently, there is no effective treatment for RE, which significantly impacts patients′ quality of life. RE treatment strategies primarily relies on symptomatic treatment to alleviate symptoms, however, existing medications have limitations, such as brief intestinal retention, inadequate targeting, and significant toxicities and side effects. These limitations not only undermine the therapeutic effect of RE but also reduce patient compliance. Therefore, the development of innovative drug delivery systems that aim to enhance the efficacy and reduce the toxicity of RE treatment is of utmost importance. The authors provided an overview of the pathogenesis and conventional treatment strategies for RE, while emphasizing the research progress and application prospects of hydrogel drug delivery systems in RE treatment, aiming to provide a theoretical support for the development of novel RE hydrogel drug delivery systems and their translation into clinical practice.