In recent years, the rapid advancement of nanotechnology and tumor biology has significantly expanded the application of nanomaterials in cancer therapy, particularly through the induction of programmed cell death (PCD) in cancer cells. Layered double hydroxides (LDH), a class of two-dimensional inorganic nanomaterials, have attracted considerable attention due to its tunable structures, excellent biocompatibility, and superior drug delivery capabilities. Emerging research has highlighted the great potential of LDH in modulating various forms of PCD. In this review, we provide a comprehensive overview of recent progress in the use of LDH to regulate different PCD pathways in cancer cells, including apoptosis, autophagy, ferroptosis, cuproptosis and pyroptosis. It emphasizes the underlying mechanisms of action, material design strategies, and the application of LDH in precise cancer therapy. Finally, this review is concluded with perspectives on the key challenges and bottlenecks of bioactive LDH in cancer therapy, providing potential solutions and outlining future perspectives.