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Cancer is a leading cause of death in both China and developed countries due to its high incidence and low cure rate. Immune function is closely linked to the development and progression of tumors. Platelets, which are primarily known for their role in hemostasis, also play a crucial part in the spread and progression of tumors through their interaction with the immune microenvironment. The impact of platelets on tumor growth and metastasis depends on the type of cancer and treatment method used. This article provides an overview of the relationship between platelets and the immune microenvironment, highlighting how platelets can either protect or harm the immune response and cancer immune escape. We also explore the potential of available platelet-targeting strategies for tumor immunotherapy, as well as the promise of new platelet-targeted tumor therapy methods through further research. • Platelets can affect the immune environment by either aiding or hindering the immune response and helping cancer cells evade the immune system. • Possible benefit of anti-platelet agents in cancer patients has been discussed, along with the underlying mechanisms. • The potential of available platelet-targeting strategies for tumor immunotherapy was presented. • Questions have been raised about the role of platelets in the immune needs of tumor cells during cancer development and spread. [ABSTRACT FROM AUTHOR]