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This article reviews the autonomous manipulation strategies of biological cells utilizing optical tweezers, mainly including optical direct and indirect manipulation strategies. The typical and latest achievements in the optical manipulation of cells are presented, and the existing challenges for autonomous optical manipulation of biological cells are also introduced. Moreover, the integrations of optical tweezers with other manipulation tools are presented, which broadens the applications of optical tweezers in the biomedical manipulation areas and will also foster new developments in cell-based physiology and pathology studies, such as cell migration, single cell surgery, and preimplantation genetic diagnosis (PGD).