Gynecological malignancies seriously threaten women’s health. Although current treatment strategies are relatively effective, relapse and drug resistance are still important factors affecting the overall survival rate of malignancies. Studies have shown that tumor recurrence and drug resistance are closely related to cancer stem cells (CSCs) subpopulations with self-renewal, infinite proliferation, multi-directional differentiation potential, and high tumorigenicity. Musashi-1 is a CSCs marker reported by the latest research. Most studies believe that it plays a role through signaling pathways such as Notch and Wnt. It is abnormally expressed in a variety of tumor tissues and highly expressed in gynecological malignant tumors. Besides, Musashi-1 is closely related to tumor stage, differentiation, vascular invasion and chemotherapy resistance. The in-depth study of its action mechanism in gynecological malignant tumors can provide new ideas for the clinical treatment of gynecological malignant tumors. This manuscript reviews the expression and action mechanism of Musashi-1 in gynecological malignant tumors.