<p>Malignant tumors are a major cause of death worldwide, making precise diagnosis and individualized treatment strategies crucial for improving prognosis. Percutaneous minimally invasive ablation, utilizing physical (e.g., thermal, cryo-) or chemical energies, has become a cornerstone alternative to surgery for solid tumors. This review systematically examines the mechanisms, clinical efficacy, and limitations of major ablation modalities, including radiofrequency, microwave, cryoablation, high-intensity focused ultrasound, irreversible electroporation, and photodynamic therapy. It critically appraises advances in local control, explores the synergistic potential of combining ablation with immunotherapy, and highlights the role of artificial intelligence in enhancing precision. We emphasize that optimizing outcomes hinges on tailored technique selection based on tumor biology and anatomy, supported by technological innovation and multidisciplinary collaboration within standardized treatment frameworks.</p> Graphical Abstract <p></p>