Purpose of review: Malignancy-related hemorrhage is a complex and potentially life-threatening complication that requires a multidisciplinary approach. This review examines the role of endovascular interventions in achieving hemostasis when conservative measures fail, focusing on their indications, efficacy, and associated risks.

Recent findings: Endovascular therapies have demonstrated high success rates in controlling hemorrhage from various malignancies. Bronchial artery embolization (BAE) effectively manages hemoptysis in lung cancer, though recurrence remains a challenge. Gastrointestinal tumor bleeding can be treated with targeted embolization, but ischemic complications require careful technique. Hematuria due to urinary and prostate malignancies responds well to superselective embolization, and uterine artery embolization (UAE) is a viable option for gynecologic malignancy-related bleeding. Emerging techniques, such as bronchial artery chemoembolization, show promise in improving long-term control. Endovascular interventions are a cornerstone in the management of malignancy-related hemorrhage, offering minimally invasive and effective hemostatic solutions. While recurrence and complications remain a concern, advancements in embolization techniques and materials continue to improve outcomes. A multidisciplinary approach is essential to optimizing patient care.

Keywords: Bronchial artery embolization; Embolization; Endovascular therapy; Gastrointestinal bleeding; Hematuria; Hemoptysis; Hemostasis; Interventional oncology; Malignancy-related hemorrhage; Transcatheter embolization; Uterine artery embolization.

© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.