Malignant tumors are complex organs consisting of tumor cells and their microenvironment. Increasing evidence has shown that the tumor microenvironment is critical to the initiation and progression of tumors. Rational design of tumor therapies via targeting the tumor microenvironment to inhibit tumor growth is thus becoming a consensus strategy. Gd@C 82 (OH) 22 nanoparticles, as novel endohedral hydroxylated metallofullerenes, have been demonstrated to be a potent antitumor nanomedicine via targeting multiple factors in the tumor microenvironment. Gd@C 82 (OH) 22 nanoparticles possess excellent biocompatibility and remarkable antineoplastic activity, as a result not of direct tumor cytotoxicity but of their diverse biological effects, including antioxidation, immune activation, angiogenesis inhibition, imprisoning cancer cells, and reversal of drug-resistance. In this article, we summarize the unique nanoscale physiochemical properties and the antineoplastic activities of Gd@C 82 (OH) 22 nanoparticles, and focus on the mechanisms underlying their regulation of the tumor microenvironment.