NCAM is a tumour associated antigen expressed on small cell lung cancer, neuroblastoma, rhabdomyosarkoma, brain tumours, multiple myelomas and acute myeloid leukaemia. Constant and strong expression of NCAM is a prerequisite for the development of antibody-based immunotherapies. From the spectrum of existing anti-NCAM compounds, radioimmunoconjugates and immunotoxins represent the clinically most advanced and successful strategies. Here we provide an overview of the evolving field of anti-NCAM immunotherapy for cancer and discuss its indications and limitations.