Peroxisome proliferator-activated receptor-γ coactivator 1-α (PGC1α) is a crucial regulator of mitochondrial biogenesis and oxidative metabolism, with its activity and expression linked to various diseases. In recent years, there has been a growing body of research on the relationship between PGC1α and cancer. The role of PGC1α in tumors exhibits significant heterogeneity, with both overexpression and underexpression of PGC1α reported to be associated with tumor occurrence, development, and prognosis, emphasizing its critical role in tumorigenesis and progression. Therefore, this article comprehensively reviews the classification, structure, function, activity regulation, and pro-carcinogenic and anti-carcinogenic effects of PGC1α, as well as its roles in oral cancer, aiming to provide a valuable theoretical reference for targeted energy metabolism therapy of malignant tumors.