This review explores the molecular mechanisms and therapeutic targets of cell death pathways in cancer. It highlights the importance of understanding and manipulating apoptosis, necroptosis, autophagic cell death, ferroptosis, and pyroptosis to develop effective cancer treatments. The article discusses the role of genetic and epigenetic factors, signaling pathways like PI3K/AKT/mTOR, MAPK/ERK, and NF-κB, and the tumor microenvironment (TME) in regulating cell death. It also reviews emerging therapeutic strategies, including BH3 mimetics, TRAIL, chloroquine, and approaches to induce ferroptosis and pyroptosis. The review emphasizes the potential of these strategies to overcome drug resistance and improve cancer therapy outcomes.This review explores the molecular mechanisms and therapeutic targets of cell death pathways in cancer. It highlights the importance of understanding and manipulating apoptosis, necroptosis, autophagic cell death, ferroptosis, and pyroptosis to develop effective cancer treatments. The article discusses the role of genetic and epigenetic factors, signaling pathways like PI3K/AKT/mTOR, MAPK/ERK, and NF-κB, and the tumor microenvironment (TME) in regulating cell death. It also reviews emerging therapeutic strategies, including BH3 mimetics, TRAIL, chloroquine, and approaches to induce ferroptosis and pyroptosis. The review emphasizes the potential of these strategies to overcome drug resistance and improve cancer therapy outcomes.