Tsunade's trademark ability is her incredible raw strength with which she is able to perform such feats as launching her targets several metres with a mere finger flick or create fissures with a single finger jab at the ground. An opponent struck by her attacks could suffer damage ranging from broken bones, ruptured organs, or even death, as Jiraiya learned for his perverted actions in his youth. While a medical-nin normally tries to avoid direct battle, Tsunade’s close-range combat skills have been considered unsurpassed, which she uses mainly to intimidate her opponents from approaching her in order to carry out her primary duties as a medical-nin. When entering battle directly, she is a force to be reckoned with as seen when she easily shattered Madara Uchiha Susanoo's ribcage, its sword, and later knocking down a complete version of the Susanoo with single punches. She was also able to obliterate Madara's body with a single attack, forcing him to use the Wood Clone Technique to escape being sealed.
As a field medical-nin, Tsunade is highly skilled in the art of evasion. In battle, she has shown great ingenuity, able to quickly pick up on her opponent's fighting style and battle pattern to better avoid damage and plan her attacks around that. These traits are to keep herself alive in battle so she may heal her team-mates; things she drilled into Sakura while training her. While not her most prominent trait, she is quite fast and equally fierce in battle, having displayed high levels of quickness to the point that her opponents find her an overwhelming adversary. She was able to incapacitate Shizune with a quick strike before she could react, use the Body Pathway Derangement technique on Kabuto when he thought she was incapacitated, block Orochimaru from attacking an unconscious Naruto even though she was severely wounded, and even intercept Manda mid-bite while lifting Gamabunta's sword. Before Mei Terumi or any of the other Kages could react, Tsunade intercepted all five of Madara's fire bullets and bat them all away.
Stamina and Life Force Edit
As a Senju, Tsunade inherited an incredible life force passed down from her earliest ancestors. She also has immense vitality, stamina, durability, and endurance which stems from this life force. Testaments to these include her still being able to move after having her muscles were torn — something Kabuto noted was an impressive and praise-worthy feat no ordinary person could achieve. During her fight with Orochimaru, she was able to push herself to fight on despite being tired and injured. She was also able to survive the life-risking Heavenly Transfer Technique, receiving only minor injuries in the process. Furthermore, her endurance was great enough to survive the normally fatal injuries of being stabbed straight through the shoulder, abdomen, and even chest to still land a powerful blow to Orochimaru. She was also to continue fighting with extreme force against Madara's Susanoo army despite being impaled through her abdomen with two Susanoo blades. Even after being bisected, she was still able to survive the ordeal, maintain consciousness, summon Katsuyu, and feel confident she could survive long enough to heal the other Kage before being healed herself.
While normally appearing carefree or short-tempered, Tsunade is a capable leader. A keen thinker, Tsunade has repeatedly been highly observant and analytical, allowing her to see through most deceptions and is rarely caught off-guard. Most commonly, Tsunade will choose the best ninja available to construct a team after looking over the assigned mission. In the anime, she was able to analyse and replicate the basic mechanics of Kabuto’s regeneration technique to aid in bettering the chances of Rock Lee's life-risking surgery being a success.
Her intelligence is most renowned as the best in the world for her expertise in all areas of medicine. She has been credited with creating the official Medical-nin system and the laws that govern them. She can immediately determine what kind of injuries or illness (physical or mental) a person has from a single glance. In addition to this, Tsunade seems to have a vast knowledge of poisons and herbal medicine, as noted by Chiyo who stated that during the Second Great Shinobi War, Tsunade was the only one capable of countering all her poisons perfectly. She also has remarkable knowledge of the human psyche, as she was able to effortlessly undo the damage to Kakashi and Sasuke's minds inflicted by Itachi's Tsukuyomi in a matter of seconds. Tsunade has also proven to be a very capable teacher, having single-handedly trained Sakura and Shizune and passed on much of her knowledge make them become two of Konoha's best medical-nin and field support.
Her mental stability is also noteworthy as she overcame her paralysing fear of blood through willpower alone, something every eyewitness found miraculous.
Chakra Reserves and Control Edit
Tsunade's Yin Seal.
Tsunade has shown to have great supplies of chakra. She has able to simultaneously heal a large number of people with the help of Katsuyu over long periods of time without becoming fatigued.
When needed, Tsunade can also release a large amount of stored chakra using Yin Seal. Upon its release, Tsunade can either use the stored chakra to facilitate the activation of one of her techniques such as the Creation Rebirth, which makes her virtually immortal in battle or simultaneously heal and protect the entire citizens of Konoha from a very powerful attack such as Pain's Shinra Tensei. She is also able to transfer chakra to others as seen when gave Ōnoki some of her chakra in order to facilitate his large-scale Dust Release: Detachment of the Primitive World Technique and still manages to maintain the activation of her Strength of a Hundred Technique.
Even more impressive than her reserves is Tsunade's control. Since a young age, Tsunade excelled in all forms of chakra manipulation; even able to maintain multiple techniques at once. Her innate talent for it allows her to gather her chakra from any part of her body with such precision and perform any technique to their maximum potential without any wasted chakra or timing. Her signature ability with chakra control is to instinctively amplify her already legendary strength with chakra control to monstrous levels, allowing her to perform feats like causing gigantic craters with a simple punch or kick to the ground, launch Gamabunta's tantō into the air and then guide it down right into Manda's mouth, and destroy Madara Uchiha's Susanoo's ribcage and its sword with relative ease. This is done by building up and releasing her chakra with precise timing upon impact, making it effortless for her to decimate any target.
Transformation Technique Edit
Even though she is in her early fifties, Tsunade's Transformation Technique makes her appear as if she were still in her twenties (which Naruto calls "living a lie"). She readily alters what age she appears in order to avoid her gambling debts. Tsunade's transformation is somewhat different from a normal transformation, as it seems to be permanent, not getting dispelled when she is slashed or injured, and she apparently does not need to exert any effort to stay transformed. She is able to maintain her transformation even while asleep. The transformation dispels when she runs out of chakra, reverting her to her natural appearance.
Medical Ninjutsu Edit
Tsunade using Creation Rebirth.
Much of Tsunade's fame comes from her being able to perform any procedure flawlessly to cure and heal injuries that others would consider impossible or a lost cause. She can do so through the usage of no more than chakra or basic tools. She healed the psychological damage caused by Tsukuyomi, the damage done to Rock Lee's spine, and counteracted the effects of the Three Coloured Pills on Chōji, something Chōza stated would have been impossible if she weren't there. Tsunade has also been noted to be capable of making powerful sleeping potions that are also colourless; so much that she is the only one in the world who could spike a drink without a ninja knowing it was drugged.
With her remarkable knowledge of the human body and converting her chakra into electricity, Tsunade is capable of sending electric waves into the opponent's nervous system by striking the back of the neck. This then scrambles the electric signals within them and disrupts the way their body moves, such as attempting to move the right hand would cause the left leg to move instead, and so on. It is unknown if this is Lightning Release. In a similar manner, Tsunade has also shown the ability to use medical ninjutsu adversely and use it to harm, even kill, instead of heal. She can use a single chakra-infused strike to effortlessly cause internal damage or incapacitate a target as she did the latter to Shizune when she tried to stop Tsunade from meeting with Orochimaru. Tsunade is also able to create a Chakra Scalpel both for surgery and to inflict internal lacerations and even attack the internal organs.
The most extreme example of her medical prowess is her Creation Rebirth, a technique that makes use of the massive amounts of chakra stored in her Yin Seal to continuously create new cells in her body, healing any wound and even growing back missing organs. It gives her a form of "immortality" in battle that even Orochimaru expressed envy for. However, as cells can only divide and be created a set amount of times, the technique shortens her life-span. Because of the risk associated with the technique, Tsunade only uses Creation Rebirth in extremely desperate situations. This technique is considered as the absolute pinnacle of medical ninjutsu, and Tsunade developed it under the resolution of protecting those dear to her. She also created an extension of the Creation Rebirth known as the Strength of a Hundred Technique, which causes the seal to extend all the way down her body. While this technique is active, any wounds Tsunade receives will heal instantaneously, without the need to make hand seals or even a conscious effort.
Summoning Technique Edit
Tsunade's summon, Katsuyu.
Tsunade can summon slugs of varying sizes, although she has only ever been seen summoning Katsuyu. The slugs' primary abilities seem to revolve around spitting acid and splitting into smaller slugs. Tsunade apparently has a mental connection with Katsuyu, as she was able to get reports and send out messages through Katsuyu during the invasion of Pain. Tsunade can transfer her chakra to a large number of slugs over long distances. By having the slugs spread out and attach themselves to wounded individuals, Tsunade is then capable of healing multiple injuries at different locations simultaneously. This technique proved particularly helpful during the Invasion of Pain which helped Tsunade preserve the life of the majority of the village even after a devastating attack by the enemy forces.
Other Skills Edit
In the anime, Tsunade demonstrated noticeable skill in a variety of other areas. When dealing with the Legendary Stupid Brothers, her skill in genjutsu was great enough to bind the immensely strong duo at once. She was also able to use Space–Time Ninjutsu to send one of Katsuyu's divisions to Team Three's location despite the great distance.
Tsunade is also well-versed in fūinjutsu, capable of developing an S-rank seal that continuously stores up chakra for various reasons including using the high-level techniques such as the Creation Rebirth technique which she also created. In the anime, she designed the Four-Corner Sealing Barrier which can be used to seal a tailed beast from scratch.