Natural killer (NK) cell-based immunotherapies have shown promising outcomes in early clinical trials, with satisfactory efficacy and safety. Recent advancements have significantly enhanced the therapeutic potential of NK cells by improving their recognition and cytotoxic capacities through surface receptor engineering. This review focuses on the impact, challenges, and future directions of receptor engineering in NK cell therapy. Most approaches involve engineering chimeric antigen receptors (CARs) to enable NK cells to target specific tumor antigens independently of human leukocyte antigen (HLA) restriction. This has increased the precision and potency of NK-mediated recognition and elimination of cancer cells. Additionally, engineering NK cells with T-cell receptors (TCRs) has broadened the range of target peptides by mediating the recognition of intracellular epitopes. Indirect tumor peptide recognition has also been improved by optimizing immunoglobulin constant fragment receptor expression and signaling. Receptor engineering has also enhanced the expansion, persistence, and infiltration of transferred NK cells in the tumor microenvironment. Strategies for sustained NK cell functionality within the tumor environment, such as logic-gated synthetic circuits and adapter CARs, have been discussed. These approaches aim to counteract tumor-induced immunosuppression and improve the overall effectiveness of NK cell-based cancer immunotherapies. Overall, receptor engineering has led to significant advances in NK cell-based cancer immunotherapies. As technical challenges are addressed, these innovative treatments are likely to reshape cancer immunotherapy.Natural killer (NK) cell-based immunotherapies have shown promising outcomes in early clinical trials, with satisfactory efficacy and safety. Recent advancements have significantly enhanced the therapeutic potential of NK cells by improving their recognition and cytotoxic capacities through surface receptor engineering. This review focuses on the impact, challenges, and future directions of receptor engineering in NK cell therapy. Most approaches involve engineering chimeric antigen receptors (CARs) to enable NK cells to target specific tumor antigens independently of human leukocyte antigen (HLA) restriction. This has increased the precision and potency of NK-mediated recognition and elimination of cancer cells. Additionally, engineering NK cells with T-cell receptors (TCRs) has broadened the range of target peptides by mediating the recognition of intracellular epitopes. Indirect tumor peptide recognition has also been improved by optimizing immunoglobulin constant fragment receptor expression and signaling. Receptor engineering has also enhanced the expansion, persistence, and infiltration of transferred NK cells in the tumor microenvironment. Strategies for sustained NK cell functionality within the tumor environment, such as logic-gated synthetic circuits and adapter CARs, have been discussed. These approaches aim to counteract tumor-induced immunosuppression and improve the overall effectiveness of NK cell-based cancer immunotherapies. Overall, receptor engineering has led to significant advances in NK cell-based cancer immunotherapies. As technical challenges are addressed, these innovative treatments are likely to reshape cancer immunotherapy.