Adhesions between homologous cancer cells play an important role in promoting tumor progression and designing tumor-targeting methods. Known as 'homologous adhesions' of cancerous cells, these are usually more specific than adhesions to normal cells and heterogenic cells, and they have been widely discovered both in vivo and in vitro. The aberrant expression of cell adhesion-related molecules (CARMs) on each species of cancer cells is mainly responsible for inducing more specific homologous adhesions. Based on the improvement of biomimetic technologies, such adhesion has been investigated and applied deeply in drug delivery systems recently. Areas covered: This review focuses on the discovery, mechanism and application of homologous adhesion and aims to assist researchers with a clear understanding for more effective development. The advantages and challenges of recent research progress and therapeutic applications are also described and discussed. Expert commentary: Homologous adhesion shows promise in providing new strategies for targeted drug delivery and tailored cancer treatments. However, the 'homing' property of certain cancer cell types remains unclear and needs to be further defined.