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Abscopal effects are characterized by the emergence of neoplasms in regions unrelated to the primary radiation therapy site, displaying a gradual attenuation or regression throughout the progression of radiation therapy, which have been of interest to scientists since Mole's proposal in 1953. The incidence of abscopal effects in radiation therapy is intricately linked to the immune system, with both innate and adaptive immune responses playing crucial roles. Biological factors impacting abscopal effects ultimately exert their influence on the intricate workings of the immune system. Although abscopal effects are rarely observed in clinical cases, the underlying mechanism remains uncertain. This article examines the biological and physical factors influencing abscopal effects of radiotherapy. Through a review of preclinical and clinical studies, this article aims to offer a comprehensive understanding of abscopal effects and proposes new avenues for future research in this field. The findings presented in this article serve as a valuable reference for researchers seeking to explore this topic in greater depth. [Display omitted] • Our review focused on elucidating the biological determinants that modulate the manifestation of abscopal effects, such as the innate and adaptive immune systems, as well as molecular factors encompassing p53 genes, mitochondria, and exosomes. • An overview was conducted on the physical variables that impact abscopal effect, encompassing radiation modality, radiation dosage, and radiation fractionation. • A comprehensive review was performed on clinical instances and research studies, yielding crucial references and substantiating evidence for further investigation into the clinical investigation of abscopal effects. • The findings presented in this article serve as a valuable reference for researchers seeking to explore this topic in greater depth. [ABSTRACT FROM AUTHOR]