Abstract: Fibroblast activation protein (FAP)-targeted radiopharmaceuticals have attracted increasing attention in the integrated diagnosis and treatment of malignant tumors. FAP, a protein expressed in the tumor stroma, plays a pivotal role in tumor progression and metastasis, making it a promising target for tumor treatment. Radiopharmaceuticals targeting FAP have demonstrated their potential to achieve precise targeting of tumor cells and surrounding stromal cells in vivo, thereby enabling non-invasive visualization and internal irradiation therapy of malignant tumors. This article provides a comprehensive review of the mechanism and research progress of FAPrelated radiopharmaceuticals and their clinical translation followed by current challenges and future directions, with the goal of providing innovative ideas and methods for the precise diagnosis and treatment of malignant tumors.