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The lysyl oxidase (LOX) family of enzymes, consisting of LOX and lysyl oxidase-like enzymes (LOXL1-4), is involved in ECM remodeling by catalyzing the crosslinking of collagen and elastin. Dysregulation of these enzymes is implicated in the pathogenesis of various diseases, including organ fibrosis and tumor development. Furthermore, LOX family members have been shown to affect radiotherapy responses, with specific involvement in radioresistance and radiation-induced fibrosis. This review summarizes the structural and functional characteristics of the LOX family, highlighting their roles in fibrotic diseases such as pulmonary fibrosis, liver fibrosis, and cardiac diseases, their roles in tumor progression, relevance in radiotherapy, and treatment targeting LOX and LOXLs. 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