Abstract Piezoelectric catalysis enhances therapeutic outcomes in nanocatalysis but is limited by intrinsic catalysis mechanism. This study employs sub-nanometer Hf 0.5 Zr 0.5 O 2 (HZO) nanowires as a piezoelectric catalyst to address these challenges. Oxygen K-edge X-ray absorption spectroscopy and spherical aberration-corrected transmission electron microscopy reveal the orthorhombic phase ( Pca21 ) in HZO nanowires. This structure imparts polymer-like flexibility to Hf 0.5 Zr 0.5 O 2 , improving its sensitivity to mechanical stress. Molecular dynamics and first-principles calculations demonstrate that ultrasonic stimulation increases the mobility of oxygen bridges, facilitating efficient ferroelectric polarization reversal. This mechanism breaks the “scaling relationship” between the low activation energy for reactant adsorption and the high activation energy for product desorption, enabling significant hydroxyl radical generation. Additionally, hydrogen produced during catalysis promotes pyroptosis, enhancing CD8 + T cell infiltration and reversing tumor immunosuppression. This research underscores the potential of sub-nanoscale ferroelectric materials in anti-tumor applications.