This review delves into the principles of PET imaging and radiomics, emphasizing their importance in detecting, staging, and monitoring various cancers. It highlights the clinical applications of PET radiomics in oncology, showcasing its impact on personalized cancer care. Additionally, the review addresses challenges such as standardizing PET radiomics, integrating multiomics data, and ethical concerns in clinical decision-making. Future directions are also discussed, including broader applications of PET radiomics in clinical trials, artificial intelligence integration for automated analysis, and incorporating multiomics data for a comprehensive understanding of tumor biology.