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BACKGROUND Cancer is increasingly becoming the major cause leading to death in many countries, and digestive system malignant tumours account for the majority of cancer incidence and mortality. Metabolism has been identified as a core hallmark of cancer. Peroxisome proliferator activated receptor gamma coactivator alpha (PGC-1α) is a pivotal regulator of mitochondrial energy metabolism. Accumulating evidence reveals that PGC-1α is essential in cancer development. OBJECTIVE We summarize the latest research progress of PGC-1α in common digestive system malignant tumours. Some related modulators and pathways are involved as well. METHODS We conducted a literature review of the development about PGC-1α in common digestive system malignant tumours. RESULTS In colorectal cancer, PGC-1α appears to provide growth advantages by different pathways, although it has also been reported to have opposite effects. The previous studies of PGC-1α on liver cancer also demonstrate different effects by sundry pathways. Concerning gastric cancer, PGC-1α promotes cell proliferation, apoptosis in vitro and tumour growth in vivo. AMPK/SIRT1/ PGC-1α is related to the inhibition of apoptosis in pancreatic cancer cells. Pancreatic cancer stem cells are strongly dependent on mitochondrial oxidative phosphorylation. PGC-1α is required to maintain the stemness property of pancreatic cancer stem cells. CONCLUSION We expose diverse mechanisms that explain the dichotomous functions of PGC-1α on tumorigenesis, as well as discuss the latest research concerning digestive system malignant tumours. This review would supply better comprehension of the field and a basis for further studies associated with PGC-1α in digestive system cancers.