Cell-based cancer vaccines represent a groundbreaking immunotherapeutic strategy that leverages the host's immune system to precisely identify and eradicate malignant cells. These vaccines function by enhancing immune recognition of tumour-associated or tumour-specific antigens, thereby amplifying antitumor immunity. Current platforms predominantly employ autologous or allogeneic tumour cells, dendritic cells (DCs), DC-tumour fusion hybrids, or other immunocompetent cells as antigen-presenting vehicles. While preclinical investigations and phase I/II clinical trials have demonstrated promising immunogenicity and clinical outcomes, significant translational challenges persist. This review delineates diverse cell-based vaccine platforms, elucidates their mechanisms for modulating antitumor immunity, explores rational combinatorial approaches with complementary immunotherapies, and showcases recent clinical advances within this rapidly evolving domain.