The burst generation of reactive oxygen species serves as a key driver of radiation injury. Efficient scavenging of excessive reactive oxygen species and restoration of redox homeostasis represent a critical therapeutic strategy for radiation injury repair. However, conventional antioxidants have limitations such as poor stability, weak targeting capability, and low bioavailability. Nanomaterials, distinguished by their unique size effects, high specific surface area, and functional plasticity, have brought new ideas for this field. This review summarizes the pathological mechanisms of reactive oxygen species-mediated radiation injury, then systematically reviews the research progress on strategies targeting reactive oxygen species to modulate radiation injury repair based on nanomaterial types, delves into the molecular mechanisms and application prospects of nanomaterials in scavenging reactive oxygen species, breaking the inflammatory cycle, and promoting tissue regeneration, and finally provides an outlook on the challenges of clinical translation and future directions for intelligent nanomedicines, with the aim of providing theoretical references and research ideas for breaking through the limitations of traditional antioxidants and advancing mechanistic research and clinical translation in the protection and repair of radiation injury.
