This review describes the available works on four main trends of prospective application and study of melatonin in oncology: the main properties and mechanisms of the antitumor effect of melatonin, melatonin as a direct antitumor agent, melatonin as a drug for the accompanying therapy of psychoemotional disorders and sleep disorders in cancer patients, and melatonin as a drug for the accompanying therapy of chronic pain syndrome in oncology. Currently, researchers focus on fundamental and clinical relationships between circadian rhythms and carcinogenesis, and one of the key problems is the potential of melatonin as an agent capable of interfering with the molecular processes of formation and maintenance of the viability of malignant tumors. An equally important problem is the potential of melatonin in terms of using its physiological properties for the prevention and accompanying therapy of undesirable effects of the main treatment in oncological practice, which is emphasized in this review. The purpose of this review is an unbiased study of the prospects for the multidirectional use of melatonin both as a direct antitumor agent and as a component of complex therapy of concomitant adverse events associated with tumor and the treatment. Based on a detailed analysis of original scientific articles and scientific reviews in the PubMed search system, as well as peer-reviewed Russian journals, authors have made an attempt to characterize the current state of melatonin in oncology based on principles of evidence-based medicine. Authors also suggests and justify key prospects for use of melatonin in oncology practice and the range of studies necessary to clarify its properties and place in the combined therapy of malignant neoplasms.Received 9 July 2021. Revised 18 August 2021. Accepted 19 August 2021.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.Contribution of the authors Conception and study design: I.I. Eremenko, V.E. Ponomarev Drafting the article: I.I. Eremenko, V.E. Ponomarev, S.B. Polikarpova, E.A. Bogush, V.Yu. Kirsanov, B.A. Zisman, M.M. Davydov Critical revision of the article: I.I. Eremenko, V.E. Ponomarev Final approval of the version to be published: I.I. Eremenko, V.E. Ponomarev, S.B. Polikarpova, E.A. Bogush, V.Yu. Kirsanov, B.A. Zisman, M.M. Davydov