Photodynamic therapy (PDT) is an established method for the treatment of cancer which utilizes light, a photosensitizer (PS), and oxygen. Unfavourable characteristics of most PSs, such as low solubility and tumour specificity have led many researchers to adopt nanoscale drug delivery platforms for use in PDT. Mesoporous silica nanoparticles (MSNs) form a significant part of that effort, due to their ease and controllability of synthesis, ease of loading, availability of diverse surface functionalization, and biocompatibility. Therefore, in this review, we discuss the properties of MSNs as they pertain to their use in PDT and review the latest advances in the field, comparing the different approaches currently being used.