Mast cells are of paramount importance in allergic reactions, pathogen immune responses during infection, and angiogenesis, as well as innate and adaptive immune regulation. Beyond all these roles, mast cells are now increasingly being recognized as modulators of tumor biology and fate. Notwithstanding mounting evidence of mast cell accumulation in tumors, their exact role in tumorigenesis and tumor progression is still incompletely understood. Although some evidence suggests that mast cells can promote tumorigenesis, there are some clinical sets as well as experimental tumor models in which mast cells seem to have functions that favor the host. This article focuses on the significant roles of mast cells in the mechanism, early diagnosis, differential diagnosis and evaluation of prognosis of gynecological neoplasms, with particular emphasis on the capacity of these cells to stimulate tumor growth by promoting angiogenesis, and highlight recent findings on the integral roles of mast cells in gynecological neoplasm growth, such as cervical and breast cancer. Information to be presented suggests that mast cells may become useful tools for future anticancer therapies.