Abstract: Sonodynamic therapy represents a cutting-edge treatment technique, and it leverages external ultrasound to activate sonosensitizers, generating reactive oxygen species, thereby causing irreversible oxidative stress damage to cancer cells to combat tumors. This approach boasts non-invasiveness, low skin sensitivity, and exceptional tissue penetration. In recent years, with the rapid advancement of nanotechnology, bismuth-based nanomaterials have been widely employed as a novel type of sonosensitizer in sonodynamic therapy for cancer, owing to their excellent biocompatibility and outstanding physicochemical properties. This paper comprehensively and exhaustively elucidated the core mechanisms underlying the role of bismuth-based nanomaterials in sonodynamic cancer therapy. It systematically reviewed the latest research progress achieved in the field of cancer treatment using these materials and delves into their biosafety issues. The aim was to provide a solid theoretical foundation and reference guide for further exploration and practice of bismuth-based nanomaterials in clinical applications in the future.