Abstract: Gadolinium neutron capture therapy(GdNCT) is an innovative treatment that exert damage on tumor cells based on the capture reaction between thermal neutron and gadolinium. In comparison with other types of neutron capture therapy(NCT), gadolinium has the highest thermal capture cross section of any natural elements. Gadoliniumbased agents are widely used in magnetic resonance imaging(MRI) as contrast agents. The improvements of multiple gadoliniumbased agents have been applied to enhance therapeutic efficacy of GdNCT. In this review, principles of gadolinium neutron capture therapy were studied and diverse strategies to improve therapeutic efficacy of gadoliniumbased agents were summarized. Giving a perspective on GdNCT to prompt its clinical use.