As a valuable medicine and food homology plant suitable for people of all ages, Codonopsis pilosula has been used for dietary nourishment and medicinal purposes with high acceptance for a long history. Interest in the potential anticancer functions of C. pilosula has increased due to its numerous chemical constituents with diverse structures and extensive pharmacological activities. With the growing interest, C. pilosula-based antitumor traditional Chinese medicine (TCM) formulations are also considered as vital intervention strategy for cancer, which exhibit prospective antitumor potential with multiple targets, multiple signaling pathways, and less side effects in both experimental and epidemiological studies. However, the prospective molecular mechanisms and newly emerging research methods in cancer auxiliary regulation require further elaboration. Consequently, this review systematically presents the latest research progress and future prospect of C. pilosula and highlights current gaps in knowledge, which facilitate the great rejuvenation of C. pilosula for the long-term therapy use of tumor. Remarkably, with the gathering of the findings of biological evaluation, combinations with network computing approaches, such as network pharmacology, molecular docking, and quantum-chemical calculations, this review is expected to provide theoretical support and open further research perspectives on C. pilosula in biological function and potential clinical efficacy.