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 life-regulating processes. Various lipids and their metabolic enzymes modulating tumor cell radiation sensitivity by affecting processes such as DNA damage repair, apoptosis, and autophagy. The authors reviewed the research progress on the relationship between lipids and tumor radiation sensitivity, focusing on fatty acids, phospholipids, cholesterol, and their metabolic enzymes, and prospected potential regulatory targets. Targeted regulation of lipids and their associated metabolic pathways holds promise as an effective strategy for modulating tumor radiation sensitivity.