Abstract: Immune checkpoint inhibitors (ICIs) can significantly improve the overall survival rate of cancer patients. However, the effects vary in different tumor types. Identifying pathways to improve the anti-tumor efficacy of immunotherapy and reduce immune-related adverse reactions is important. Recent studies have demonstrated the importance of the innate immune response in anti-tumor therapy with ICIs. Inflammatory pathways can both improve and impair anti-tumor immunity. In this review, we focus on two factors involved in innate immunity and adaptive immune response: the inflammasome and immune checkpoints. We aimed to discuss how inflammasome activation can influence the clinical outcomes of administering ICIs and immune-related adverse reactions. This review will inform the search for targeted therapies, enhancing the efficacy of anti-tumor immunotherapy and reducing immune-related adverse reactions.