Organoids have become an important technological platform in cancer research, but simulating the primary tumor tissue structure and function still presents problems. The development of gene-editing technology, especially when combined with tumor organoids, provides a new approach for accurately and comprehensively simulating the in vivo characteristics of tumor models. Introducing specific gene mutations or correcting mutations in tumor organoids through gene-editing technology can allow detailed analysis of the mechanisms of tumor initiation and progression, as well as exploring potential therapeutic targets, accelerating the drug-screening process, and providing new insights for personalized cancer treatment. This article reviews the formation of tumor organoids and the technical aspects of gene-editing strategies, emphasizing their unique applications and prospects in tumor organoids. We also propose that accurately simulating the in vivo microenvironment, promoting the standardization and stability of organoid gene-editing technology, and optimizing the efficiency of gene editing can accelerate the application of organoids in precision medicine research.