: The role of mitochondria in apoptosis signaling cell death pathway is regulated by extrinsic and intrinsic pathway, encompassing multiple components like Bcl-2 family of proteins, death receptors, caspases, Smac/DIABLO, IAPs, Omi/HtrA2 and cytochrome c. These entities serve as effective molecular targets for numerous drugs targeting mitochondrial apoptotic pathway, mainly emphasizing on oncology therapeutics. Defective apoptosis is an acquired hallmark of cancer cells, which promotes establishment of apoptosis-targeting anti-cancer drugs in cancer treatment. The review provides an overview of the Bcl-2 inhibiting, IAPs antagonizing, caspase inhibiting and BH3 mimicking actions, mediated by anti-cancer drugs, rendering beneficial outcomes in different forms of cancer. The authors elaborate the significance of synthetic and natural agents, targeting the mitochondrial apoptotic pathway, in ameliorating tumor cell growth in the body, and the specificity and effectiveness of these agents, motivating the researchers to explore mitochondrial apoptosis targeting of anti-tumor drugs, of both herbal and synthetic origin. Thus, the review aims to prognosticate this dynamic approach in oncology, simultaneously highlighting the challenges and future prospects, providing an opportunity to the experts, to “go over with a fine tooth comb” in understanding this “programmed cell death pathway”, and establishing reliability and accuracy of this therapeutic paradigm in the upcoming future.