<p>The unique physiological characteristics and complexity of tumor, in addition to drug resistance result in traditional therapies, such as chemotherapy and radiotherapy, being unable to achieve complete elimination of cancer cells. Meanwhile, the emerging immunotherapy suffers from a low patient response rate. Bacterial therapies are highly targeted. Bacteria can penetrate deep into the tumor and show good tumor inhibition. However, natural bacteria have the limitation of high toxicity and inability to meet the demand for efficient therapeutics. Recent advances in synthetic biology and materials science relate to the safety and efficacy of bacterial therapeutics, promising to develop engineered bacteria with low toxicity and complex therapeutic functions. Engineered bacteria that express anticancer drug molecules can target the tumor region, synthesizing and releasing payloads in response to internal and external stimuli. This process leads to the regression of the tumor and the effective inhibition of recurrence. This review outlines the recent advancements in the field of engineered bacteria research, particularly focusing on their applications in anti-tumor therapy. It also includes the advantageous features and mechanisms of engineered bacteria therapy, synthetic biology modification methods, and future challenges and directions of engineered bacteria therapy.</p>