Neutrophils are predominant immune cells that protect the host from microbial infection. The roles of neutrophils in tumor have long been ignored due to their short life span and terminal differentiation phenotype. In recent years, emerging evidence indicates that neutrophils have phenotypic and functional plasticity. Neutrophils eliminate malignant cells by releasing the antimicrobial and cytotoxic contents in their granules or secreting immune mediators to recruit and activate other antitumor effector cells. On the contrary, tumor derived factors can convert neutrophils into a pro-tumor phenotype. Neutrophils have been shown to facilitate tumorigenesis, promote tumor growth and metastasis, stimulate tumor angiogenesis, and mediate immunosuppression. The number of neutrophils in blood and tumor tissues of cancer patients is associated with disease progression and patient outcome. In this review, we summarize the recent progress of neutrophils in the pathogenesis of cancer with an emphasis on neutrophil polarization. Better understanding of the mechanisms that regulate the dichotomy of neutrophils will not only shed light on their roles in cancer but also provide new approaches for cancer diagnosis and treatment.