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Drug resistance is one of the major causes of cancer treatment failures. In recent years, to combat the issue of drug resistance, a large volume of strategies has been established along the development of biomedical nanomaterials. Compared with traditional nanocarrier-based drug delivery strategies, in situ supramolecular self-assembly has emerged as a promising strategy to overcome drug resistance. This review first introduced the concept of in situ supramolecular self-assembly. The second part illustrated the mechanisms of constructing in situ supramolecular self-assembly as a multi-step process. The third part elucidated the role of in situ supramolecular self-assembly to reverse drug resistance, which included three categories: active self-assembly materials, drug-carrier self-assembly materials and drug-coupled self-assembly materials. At last, we summarized the current development of in situ supramolecular self-assembly for the reversal of drug resistance and the remaining concerns to be addressed.