Abstract: Immunotherapy has recently shown significant potential in treating malignant tumors. However, the immunosuppressive nature of the tumor microenvironment (TME) limits the number of patients who benefit from this approach. Combining ultrasound with drug-loaded microbubble technology can directly induce tumor cell death through cavitation and pore-forming effects; this promotes tumor antigen presentation and enhances immune recognition of these antigens. This strategy also modulates the immunosuppressive state of the tumor microenvironment, making it more conducive to an effective immune response. It also normalizes blood vessels and reduces interstitial fluid pressure within the tumor, as well as helps therapeutic agents or genes to penetrate tumor tissues, thereby enhancing overall immune efficacy. This review examines the use of low-intensity ultrasound combined with drug-loaded microbubbles to improve the tumor microenvironment and boost tumor immune responses.