Nano-engineered erythrocyte membrane-coated metal–organic frameworks (MOFs) have emerged as a promising strategy for advancing targeted cancer therapy. This review explores the synthesis, properties, and potential applications of erythrocyte membrane-coated MOFs in cancer treatment. The integration of MOFs with erythrocyte membranes offers several advantages, including enhanced biocompatibility, prolonged circulation time, and targeted drug delivery to tumor tissues. Biomineralization techniques, bottom-up assembly approaches, and nanoimprinting technologies enable precise control over coating architectures and drug delivery functionalities. Coated nanoparticles exhibit multifunctionality and versatility, allowing for the simultaneous delivery of therapeutic agents and imaging probes. By leveraging the unique properties of erythrocyte membranes and MOFs, coated nanoparticles offer targeted drug delivery systems with reduced off-target effects and systemic toxicity. Moreover, the integration of coated nanoparticles with other therapeutic modalities, such as immunotherapy and gene therapy, enables synergistic treatment approaches and personalized medicine strategies. Despite challenges related to manufacturing complexities and regulatory approval, nano-engineered erythrocyte membrane-coated MOFs hold significant promise for improving treatment outcomes and patient quality of life in cancer therapy. Further research and innovation are needed to optimize synthesis processes, validate efficacy through translational studies, and overcome existing hurdles for clinical translation