Abstract: Tissue fibrosis is an excessive self-healing reaction induced by organ damage. The further development of tissue fibrosis will lead to organ hypofunction and even failure, which seriously threatens human health. The current drugs used to treat fibrosis present many problems, such as low bioavailability, poor specificity and bad adverse reactions. In addition, the complex fibrotic pathological microenvironment hinders the effective delivery of drugs and reduces the therapeutic effect. Therefore, how to achieve accurate and efficient drug delivery to reverse fibrosis has become a hot research topic. Focusing on liver fibrosis, lung fibrosis and kidney fibrosis, this paper reviews the drug delivery systems and active targeting strategies recently applied in fibrosis therapies, so as to provide references for designing safe and effective anti-fibrosis drug delivery systems, also for realizing efficient treatment of fibrosis.