Abstract: Radiation therapy is one of the primary cancer treatment methods, however, tumor radioresistance significantly reduces the efficacy of radiotherapy, leading to treatment failure. Lipids, as essential components of cells, are involved in numerous regulatory processes. Recent studies have revealed that various lipids and their metabolic enzymes modulating tumor cell radiosensitivity by affecting processes such as DNA damage repair, apoptosis, and autophagy. The authors reviewed the research progress on the relationship between lipids and tumor radiosensitivity, focusing on fatty acids, phospholipids, cholesterol, and their metabolic enzymes amd prospect it discusses potential regulatory targets. Targeting lipids and their associated metabolic pathways holds promise as an effective strategy for modulating tumor cell radiosensitivity.