Tapentadol is a novel analgesic of a dual mechanism of action, the first representative of the centrally acting analgesic drugs called MOR-NRI. It has the agonistic activity towards µ receptors (MOR) and non-opioid – inhibiting norepinephrine reuptake (NRI) at the spinal cord level. These two mechanisms unveil synergy, clinically confirmed in multiple kinds of nociceptive and neuropathic pain. In this paper, we described the place of tapentadol in the treatment of tumor-related pain, in comparison to other III step opioids of the analgesic ladder.