Abstract: In the 1920s， German biochemist Warburg found that tumor cells used glycolysis for energy generation to maintain survival even under aerobic conditions， a phenomenon known as the Warburg effect. However， a growing number of studies have found that not all kinds of tumor showed the Warburg effect， or not all of tumor cells used the Warburg effect for energy generation. There is the diversity of metabolism in tumor cells. Some cells used glycolysis for energy production， but other cells used oxidative phosphorylation for energy production. Two types of cells can mutually coordinate and coexist with each other through lactic acid shuttle system， which is named metabolic symbiosis. This review will discuss the material basis of metabolic symbiosis and symbiosis phenomenon among cells in tumor. This review will also discuss the effect by metabolic symbiosis on characteristics of tumor cells and the clinical significance of metabolic symbiosis. A fully understanding of metabolic symbiosis in tumor cells is helpful for designing new and effective anti-cancer treatment strategies.