Fatigue is one of the most common adverse effects of cancer that might persist for years after treatment completion. Among the biological mechanisms underlying cancer-related fatigue, inflammation processes have a key role in the development and persistence of this symptom. In addition, genetic, biological, psychosocial, and behavioural risk factors are also associated with the occurrence of cancer-related fatigue. This Review describes the mechanisms, risk factors, and possible interventions for cancer-related fatigue.