The hollow fiber tumor model, also known as the hollow fiber assay (HFA), was designed by the US National Cancer Institute for the purpose of evaluating preliminary in vivo drug efficacy in a simple, rapid manner. In recent years, it has been widely used in the research and development of anti-tumor drugs, from which new and improved optimizations and applications have emerged. This paper systematically summarizes the characteristics and advantages of the HFA in anti-tumor drug screening, together with the last 10 years of progress in HFA applications. We anticipate that the HFA will play an increasingly important role in anti-tumor drug research, and the improved model of HFA will have broad applications in research on individualized cancer treatments and mechanistic studies.