Aim <p>Multidisciplinary tumor boards (MTBs) are an important part of good cancer care. They facilitate interdisciplinary discourse regarding diagnostic results and therapeutic alternatives, thereby fostering personalized and evidence-based decision-making. In Germany, MTBs are required in certified cancer centers, but there is limited knowledge regarding their structures and processes in various settings, especially outside accredited institutions.</p> Subject and methods <p>A nationwide anonymous online survey was conducted among physicians involved in the care of patients with hematological and/or oncological diseases between September 2021 and January 2022. The questionnaire, developed through expert review and pilot testing, captured structural and procedural characteristics of MTBs, participation patterns, and quality-related aspects. Descriptive analyses were performed.</p> Results <p>A total of 612 responses were included in the analysis. Most of the MTBs were organized by hospitals, with 49% conducted in a hybrid or fully virtual format. Considerable heterogeneity was observed regarding frequency, duration, and participant composition compared to noncertified centers. In MTBs in noncertified centers, it was more frequently reported that certain specialties were often or permanently not represented in the MTBs. Ambulatory oncologists were frequently involved, indicating growing cross-sector collaboration.</p> Conclusion <p>The study highlights substantial structural diversity among MTBs in Germany and underscores differences between certified and noncertified settings. In addition to their clinical role, MTBs—especially newer molecular tumor boards—are an important link between precision oncology and public health governance. Making sure that everyone has equal access to molecular diagnostics and adding MTB data to population-based cancer registries could improve public health monitoring and cancer policy based on evidence.</p>