As an emerging transdermal drug delivery technology, microneedles offer the advantage of bypassing the hepatic firstpass metabolism and reducing the discomfort associated with subcutaneous injections, thus enabling minimally invasive and painless local drug delivery. However, drug delivery using microneedles is mostly passive and the drug release rate is limited.Phototherapy has demonstrated significant potential in the treatment of cancer and skin diseases. Nevertheless, achieving optimal therapeutic outcomes generally requires high doses of photosensitizers and laser irradiation, which can lead to toxicity and skin damage. Recently, microneedles have been combined with various strategies (pH response, electro-response, phototherapy, etc.) for the treatment of various diseases. The synergistic application of microneedles and phototherapy (photodynamic therapy,photothermal therapy) can complement each other, reducing the dose of photosensitizers and photothermal agents or the intensity of laser irradiation. Consequently, this approach decreases the toxicity and damage to the skin caused by the treatment process. Moreover, the combination of microneedles and phototherapy enables precise and effective drug delivery, thereby enhancing the overall therapeutic efficacy. This article overviewed the recent research advances in the field of microneedles assisted with photodynamic and photothermal therapies for the treatment of various diseases, including cancer therapy, wound management, aesthetic medicine and other diseases, so as to serve as a valuable reference for future research.