The article reviews the development and application of nanocomposite hydrogel microneedles (HFMNs) as a theranostic toolbox for personalized medicine, particularly in cancer treatment. HFMNs are designed to integrate multiple functions, including diagnosis, therapy, and imaging, on a single platform, offering enhanced patient comfort and improved clinical translation. The review highlights the advantages of HFMNs over traditional drug delivery methods, such as better patient compliance, faster onset of action, and improved permeability and efficacy. It also discusses the challenges and future perspectives in the field, emphasizing the need for further research to optimize the design and performance of HFMNs. The article concludes by outlining the potential of HFMNs in cancer therapy, particularly in combination therapies, and their role in advancing personalized and precision medicine.The article reviews the development and application of nanocomposite hydrogel microneedles (HFMNs) as a theranostic toolbox for personalized medicine, particularly in cancer treatment. HFMNs are designed to integrate multiple functions, including diagnosis, therapy, and imaging, on a single platform, offering enhanced patient comfort and improved clinical translation. The review highlights the advantages of HFMNs over traditional drug delivery methods, such as better patient compliance, faster onset of action, and improved permeability and efficacy. It also discusses the challenges and future perspectives in the field, emphasizing the need for further research to optimize the design and performance of HFMNs. The article concludes by outlining the potential of HFMNs in cancer therapy, particularly in combination therapies, and their role in advancing personalized and precision medicine.