More and more studies have shown that the autonomic nervous system plays a crucial role in the development of various cancers. Cancer cells secrete various neuroactive molecules, including neurotrophic factors, chemokines, neural cell adhesion molecules, and axon guidance molecules, to alter the tumor microenvironment and recruit surrounding autonomic nerves to the tumor. Alternatively, they can reprogram sympathetic nerves or promote the migration of neural progenitor cells into the tumor to differentiate into sympathetic nerves, thus increasing autonomic innervation. Moreover, tumors can also act on nerve fibers through exosomes, promoting peripheral nerve infiltration. The interactions between various substances in the tumor microenvironment create a suitable environment for the occurrence of perineural infiltration. During this process, the sympathetic nervous system promotes cancer progression and poses challenges to antitumor therapy by enhancing chemotherapy resistance. In contrast, the parasympathetic nervous system exhibits both tumor-promoting and antitumor properties. Therefore, this article primarily explores the interactions between cancer and the autonomic nervous system, as well as the role of neuroactive molecules in cancer progression, and proposes potential nervous system-related antitumor treatment strategies.