OBJECTIVE To summarize the characteristics and patterns of autoimmune polyglandular syndrome （APS） induced by tislelizumab， and to provide guidance for the safe use of this drug and the treatment of APS. METHODS Using “tislelizumab” and its synonyms as search terms， a systematic search was conducted in domestic and international databases such as CNKI and PubMed to collect case reports of APS caused by tislelizumab， and descriptive analysis was performed. RESULTS A total of 12 publications were included， involving 13 patients （10 males and 3 females）. The average age of the patients was （61.62±10.43） years， with 46.15% being elderly individuals over the age of 60. The underlying diseases of the 13 patients included 8 types of solid tumors， such as non-small cell lung cancer； 1 patient had a history of diabetes mellitus， and 9 patients were receiving concomitant medications. All patients experienced damage to two endocrine glands， with most cases occurring within the first 10 cycles of treatment. The associated endocrine gland damage primarily manifested as adrenal-thyroid and thyroid-pancreatic dysfunction， with initial symptoms dominated by nonspecific manifestations such as fatigue， vomiting， and nausea. The relevant abnormal laboratory markers （such as thyroid-stimulating hormone and adrenocorticotropic hormone） were closely associated with the affected glands， and positive antibodies related to endocrine glands were detected in 6 patients. All patients received symptomatic interventions， including drug discontinuation， fluid replacement， and electrolyte correction； among them， 9 patients improved， 1 patient’s condition was stabilized， and 3 patients experienced permanent loss of endocrine gland function. CONCLUSIONS APS is a rare immune-related adverse event closely associated with tislelizumab， characterized by sudden onset， diverse and non-specific symptoms， and can cause permanent damage to the glands. Clinical treatment and management should follow the principles of “tiered diagnosis and treatment， hormone replacement therapy， and multidisciplinary collaboration”， with a focus on thorough baseline assessment， screening for high-risk factors， patient education， and long-term follow-up.