Reactive oxygen species (ROS)-mediated mechanism is the major cause underlying the efficacy of photodynamic therapy (PDT). The PDT procedure is based on the cascade of synergistic effects between light, photosensitizer (PS) and oxygen, which greatly favor the spatiotemporal control of the treatment. This procedure has also evoked several unresolved challenges at different levels including (i) limited penetration depth of light restricts traditional PDT to only superficial tumours; (ii) oxygen reliance deprives PDT treatment of hypoxic tumours; (iii) light could complicate the phototherapeutic outcomes due to the concurrent heat generation; (iv) specific delivery of PSs to sub-cellular organelles for exerting effective toxicity remains an issue; and (v) side effects by undesirable white-light activation and self-catalysation of traditional PSs. Recent advances in nanotechnology and nanomedicine have provided new opportunities to develop ROS-generating systems through photodynamic or non-photodynamic procedures while tackling the challenges of current PDT approaches. In this review, we summarize the current status and discuss the possible opportunities of ROS generation for cancer therapy. We hope this review will spur pre-clinical research and clinical practice for ROS-mediated tumour treatment.