Metabolic reprogramming is one of the important features of tumors which provides essential macromolecules for adenosine triphosphate ATP and intracellular protein and nucleotide biosynthesis thereby promoting the proliferation and survival of tumor cells. The metabolism of tumor cells is significantly different from that of normal cells and the strong plasticity of tumors is an important reason for the slow progress of targeted tumor metabolic therapy research. Research has shown that key metabolic enzymes in glucose and lipid metabolism can alter their own activity and obtain non metabolic enzyme functions in various ways thereby driving metabolic reprogramming in tumor cells. These methods mainly include abnormal protein expression mutations post - translational modifications changes in oligomeric state and subcellular translocation. Pyruvate kinase is a key enzyme in the cellular glycolytic pathway which catalyzes the conversion of phosphoenolpyruvate to pyruvate and produces adenosine triphosphate. M2 type pyruvate kinase PKM2 can promote tumor cell proliferation and synthetic metabolism by enhancing the Warburg effect. It can also enter the nucleus as a co transcription factor and protein kinase to regulate gene transcription playing an important role in malignant tumor metabolic remodeling cell proliferation and metastasis. This article summarizes the abnormal expression of PKM2 in various types of tumors its role and mechanism in tumor metabolism regulation and its application and breakthroughs in the field of traditional Chinese medicine in order to provide new ideas for clinical tumor metabolism therapy.