Abstract: In recent years, nano-metal-organic frameworks (nMOFs) have demonstrated tremendous potential in the field of early non-invasive cancer diagnosis due to their unique structural advantages, including tunable pore structures, ultra-high specific surface area, versatile surface functionalization and this relies on the diverse structural options and metal center selections, which offer excellent biocompatibility. Notably, the multifunctional designability of nMOFs enables the integration of diagnostic and therapeutic capabilities, offering an innovative solution for constructing cancer theranostic platforms. This study systematically reviews the latest research advances in nMOFs, covering controlled synthesis, intelligent functionalization, multimodal imaging, and synergistic diagnosis and therapy, aiming to provide theoretical guidance and technical support for advancing interdisciplinary integration and clinical translation in this cutting-edge field.