AbstractTransition metal dichalcogenide (TMD) quantum dots (QDs) are fundamentally interesting because of the stronger quantum size effect with decreased lateral dimensions relative to their larger 2D nanosheet counterparts. However, the preparation of a wide range of TMD QDs is still a continual challenge. Here we demonstrate a bottom-up strategy utilizing TM oxides or chlorides and chalcogen precursors to synthesize a small library of TMD QDs (MoS₂, WS₂, RuS₂, MoTe₂, MoSe₂, WSe₂ and RuSe₂). The reaction reaches equilibrium almost instantaneously (~10–20 s) with mild aqueous and room temperature conditions. Tunable defect engineering can be achieved within the same reactions by deviating the precursors’ reaction stoichiometries from their fixed molecular stoichiometries. Using MoS₂ QDs for proof-of-concept biomedical applications, we show that increasing sulfur defects enhanced oxidative stress generation, through the photodynamic effect, in cancer cells. This facile strategy will motivate future design of TMDs nanomaterials utilizing defect engineering for biomedical applications.