Abstract: Adenylate kinase 4 (AK4), a member of the adenylate kinase family, regulates the concentration of cellular ATP and plays a pivotal role in the regulation of energy metabolism in cells. It also plays a crucial role in hypoxia tolerance, tumor development, anti-tumor drug resistance, and regulation of mitochondrial activity. Malignant tumors are a serious threat to human health; the mortality rate associated with malignant tumors remains high. The occurrence, development, and treatment of malignant tumors have long been the prime focus of scientific research. Although tumor treatment is continuously improving and a steady progress is seen with regard to our understanding of tumors in general, no breakthroughs, especially the identification of therapeutic targets and strategies for the treatment of post-drug resistance, have been achieved. AK4 is a potential therapeutic target for anticancer therapy; however, the exact relationship between AK4 and tumor development has not yet been established clearly. In view of the ongoing progress and unmet challenges, this article intends to summarize the current status of research regarding AK4, aiming to provide novel ideas for clinical and disease-related studies regarding this aspect.