Tsunade

Biodata

Feature	Information
Name	Tsunade (纲手)
Alias(es)	Medical Sage; Fifth Hokage (parallel-world counterpart)
Gender	Female
Affiliation	Konohagakure; Konoha Hospital; Land of Light
Occupation/Role	Medical ninja; head of Konoha Hospital; Minister of Health in the Land of Light; Fifth Hokage in the parallel world
Status	Active
First Appearance	Chapter 18

Background

Tsunade was raised by her grandmother, Uzumaki Mito, after the early deaths of her First Grandfather, Second Grandfather, and parents. Mito's Uzumaki heritage gave Tsunade a lasting affection for members of the Uzumaki clan. 91

As one of Hiruzen Sarutobi's disciples, Tsunade became part of the Sannin alongside Jiraiya and Orochimaru. She strongly dislikes Danzō, regarding his rigid, sinister methods as unacceptable. 18

Appearance

Tsunade is a blonde woman recorded as 163.1 cm tall during her first meeting with Kizaru. She commonly works in a white medical coat. 21 137

• Blonde hair.
• Wears a white medical coat while on hospital duty. 137
• Retains a youthful appearance through a ninjutsu associated with Mito. 367

Personality

Tsunade is blunt, forceful, and quick to anger, particularly when Kizaru addresses her in ways that make her feel old or diminutive. She also has little patience for Jiraiya's complaints and Danzō's political maneuvering. 21 53 373

Her harshness is paired with deep protectiveness. She repeatedly worries over Kizaru's safety, refuses to abandon Nawaki's future to expediency, and personally treats injured shinobi when possible. 41 56 140 163

As a medical leader, she is serious about the status and treatment of medical ninja. She considers their shortage a systemic problem rather than a lack of worth, and continues working despite her desire to eventually retire and gamble. 94 414

Abilities & Skills

Medical Ninjutsu

Tsunade is an elite medical ninja and the head of Konoha Hospital. She can stabilize serious injuries in the field and rapidly mend muscle damage and minor fractures with the Mystical Palm Technique. 22 140

• Treated Jiraiya after Kizaru severely injured him. 22
• Healed Danzō's wounded arm following Kizaru's assessment battle. 27
• Restored Kizaru's strained muscles and fractured index finger with Mystical Palm Technique. 140
• Treated Might Duy's accumulated training injuries and supplied Nutrient Serum to aid his recovery. 115 135
• Formulated Nagato's treatment plan, beginning with Hashirama Cell-derived nutrient solution to rebuild his life force. 377
• Oversees difficult cases at Konoha Hospital rather than routine patients. 448

Strength Enhancement Technique

Tsunade teaches a chakra-based Strength Enhancement Technique that pairs exceptionally well with taijutsu. She initially offered it to Kizaru after recognizing his physique and potential. 21 53

• Granted Kizaru the technique's training scroll and offered daily guidance at the hospital. 53
• Identified Kizaru's use of the technique when he used it to empower a kick against Hanzō. 82
• Warned that combining the technique with the Eight Inner Gates makes chakra dangerously violent and greatly increases bodily damage. 140
• Offered to study the Eight Inner Gates herself so she could help Kizaru practice the combination more safely. 140

Medical Administration and Research

Tsunade directs medical-ninja training, hospital operations, and medical research.

• Advocated expanding medical-ninja training so that ninja squads could eventually include medical support. 41 94
• Explains that qualified medical ninja require rare aptitude and typically six to eight years of training. 94
• Trained Yakushi Nonō, who showed unusually rapid aptitude for basic healing. 175
• Supported Hashirama Cell research and later discussed cloning organs for disabled ninja. 137 221
• Helped develop a medical system in the Land of Light and compiled its medical-ninja code. 414

Relationships

• Shimura Kizaru — Initially sought to take him as her disciple after witnessing his strength; later became his fiancée and wife in Kizaru's world. Their relationship is affectionate but frequently combative. 21 53 175 414
• Nawaki Senju — Her younger brother. Tsunade is fiercely protective of him, though she ultimately supports his decision to receive Hashirama Cell implantation. 41 163
• Jiraiya — Fellow Sannin and Hiruzen's disciple. She treats his injuries but often mocks or physically reprimands him. 21 22 53
• Orochimaru — Fellow Sannin. They work alongside each other in Konoha's medical and research initiatives. 21 94 163
• Hiruzen Sarutobi — Her teacher. She challenges his decisions openly, especially when she believes Kizaru is being placed in danger. 23 56
• Uzumaki Mito — Her grandmother and primary guardian after the deaths of Tsunade's immediate family. 91
• Hashirama Senju — Her First Grandfather. She supports Kizaru's custody of the Rinnegan and asks Hashirama to trust her judgment. 21 248
• Tobirama Senju — Her Second Grandfather. Tsunade supports his policy of restraining clan privilege and favoring civilian shinobi. 137
• Nagato — An Uzumaki youth toward whom Tsunade feels familial affinity; she treats his damaged body and reprimands him for overusing the Rinnegan. 91 376 377
• Shizune — Her attendant and subordinate during her tenure as Fifth Hokage in the parallel world. 367

Story Role / Major Arcs

Kizaru's Early Career

Tsunade first takes interest in Kizaru after he defeats Jiraiya with Light Style. Suspecting that the six-year-old created the alleged Shimura Kekkei Genkai himself, she nevertheless recognizes that he may one day equal or surpass Hashirama. 21

She attempts to claim Kizaru as her disciple and offers to teach him the Strength Enhancement Technique. Hiruzen instead takes Kizaru as his public student, while Tsunade remains his taijutsu and medical mentor. 21 23 53

Second Shinobi World War

Tsunade serves Konoha's war effort by preparing hospital capacity and logistical reserves. She fiercely objects when Hiruzen assigns Kizaru to face the Land of Lightning alone, only relenting after learning of his previous raid on Kumogakure and ability to retreat by flight. 56

During the conflict with Hanzō, Kizaru saves Tsunade and wounds Hanzō using the Strength Enhancement Technique she taught him. Tsunade takes personal pride in seeing her technique used at that scale. 82

Medical-Ninja Reform

Tsunade supports Kizaru's proposal to expand medical-ninja training, although she stresses the substantial cost and lengthy training required to produce qualified practitioners. 41 94

She continues to treat Kizaru, Might Duy, and other injured shinobi while helping establish a larger medical system. When Kizaru injures himself attempting to combine the Eight Inner Gates with her technique, she heals him and insists that he stop reckless solo practice. 115 140

Hashirama Cells and Senjutsu

Tsunade initially opposes Nawaki's Hashirama Cell implantation out of concern for her brother, but accepts his decision after Kizaru mediates. 163

After learning that Kizaru's Senjutsu could extend his lifespan, she resolves to pursue Senjutsu herself so that she can remain with him. 190

Land of Light Era

After Kizaru's rise, Tsunade becomes his fiancée and later his wife. She serves as the Land of Light's Minister of Health, leads the modern medical system, and remains devoted to treating patients despite Kizaru encouraging her to take leave. 175 414

Konoha Hospital eventually becomes so crowded that only difficult cases are referred directly to Tsunade, while the government plans further hospitals across the country. 448

Parallel-World Fifth Hokage

A parallel-world Tsunade serves as the Fifth Hokage. When the parallel-world Kizaru arrives in her Konoha, she cautiously cooperates with him while restricting his ability to gain prestige through missions. 367 368

After learning that Danzō intends to use Kizaru's assumed identity to assassinate her, she works with Kizaru to reverse the trap. Danzō's ambush fails when Kizaru betrays him and severs his arm, allowing Tsunade to offer clemency to his surviving subordinates. 371 373

Trivia

• Tsunade is highly sensitive about being called old; Naruto calling her “Granny Tsunade” immediately provoked her killing intent. 349
• She has a gambling habit and is frequently teased by Kizaru over her losses. 137 414
• She supports civilian shinobi over entrenched clan privilege, reflecting her interpretation of Tobirama's political legacy. 137