Chemotherapy resistance in leukemia is an urgent clinical therapeutic challenge. Ferroptosis is a unique mode of cell death driven by iron-dependent phospholipid peroxidation. Since leukemia is characterised by increased oxidative stress and iron overload, it can be hypothesised that leukemia cells are susceptible to ferroptosis, suggesting therapeutic potential. In recent years, ferroptosis has been extensively studied and used in the treatment of various types of leukemia. Several studies have demonstrated the association between the regulatory pathways of ferroptosis and the mechanisms of leukemia drug resistance. The induction of ferroptosis through different pathways can effectively reduce the resistance of various types of leukemia cells to chemotherapeutic drugs, and thus improve the clinical efficacy. This article summarizes the regulatory mechanisms of ferroptosis, analyzes in detail the association between oxidative stress pathways and iron metabolism pathways of ferroptosis and the mechanism of leukemia drug resistance, and compiles the experimental studies and clinical applications of ferroptosis in the treatment of various types of drug-resistant leukemias, with the aim of providing new ideas and directions for the study of ferroptosis and a new strategy to reverse chemotherapy resistance for leukemia patients in the future.