Tsunade descends from the Senju and Uzumaki clans, granddaughter of Konohagakure's First Hokage, Hashirama Senju, and Mito Uzumaki. This heritage earned her the title "Princess" and granted exceptional life force, immense chakra reserves, and potent physical energy. Graduating from Konoha's Academy at age six, she joined a team with Orochimaru and Jiraiya under their mentor, the Third Hokage Hiruzen Sarutobi. Surviving a battle against Hanzō of Amegakure during the Second Shinobi World War earned them the title "Konoha's Legendary Sannin." Tsunade's advanced medical expertise and antidotes countering Sunagakure's Chiyo proved vital for Konoha's victory. The gruesome battlefield deaths of her younger brother Nawaki and her lover Dan Katō, both aspiring to become Hokage, deeply scarred her. She came to view the Hokage role as a "fool's job." Her failure to save Dan from massive blood loss triggered severe hemophobia. She departed Konoha, retiring from combat and medical duties, traveling with Dan's niece Shizune as her apprentice. Tsunade avoided direct healing, relying on Shizune, and developed notorious gambling habits inherited from Hashirama. Consistent losses earned her the epithet "The Legendary Sucker." Her return to Konoha was sparked by encountering Naruto Uzumaki, whose fierce determination to become Hokage reminded her of Nawaki and Dan. Naruto's swift mastery of the Rasengan and his defense of her during a confrontation with Orochimaru and Kabuto Yakushi helped her overcome her hemophobia. Accepting the position of Fifth Hokage following Hiruzen's death, she gifted Naruto Hashirama's necklace, a symbol of her faith in his future leadership. As Hokage, Tsunade prioritized strengthening Konoha's defenses and medical infrastructure. She mandated medical-nin training for all teams and enhanced field-medic survival protocols. During Pain's assault, she utilized the Strength of a Hundred Seal to channel chakra through her summon Katsuyu, healing the entire village simultaneously. This act exhausted her chakra. She later fought in the Fourth Shinobi World War, confronting Madara Uchiha alongside the other Kage. Despite sustaining near-fatal injuries, including bisection, she survived and coordinated healing for the allied forces. Tsunade possesses exceptional medical ninjutsu and combat abilities. Her precise chakra control enables immense strength amplification, capable of shattering Susanoo defenses or creating fissures with single strikes. She developed the Strength of a Hundred Seal, storing chakra for enhanced regeneration or power, and Creation Rebirth, rapidly healing injuries by accelerating cell division at the cost of her lifespan. She mastered techniques like the Body Pathway Derangement to disrupt opponents' nervous systems. Her slug summon Katsuyu facilitated large-scale healing and battlefield communication. She mentored Sakura Haruno, teaching her medical ninjutsu and chakra-enhanced combat, making Sakura her sole successor. Her relationship with Jiraiya involved mutual respect and unreciprocated romantic interest on his part, while she remained devoted to Dan's memory. She privately mourned Jiraiya after his death. Post-war, she retired and supported Kakashi Hatake's appointment as Sixth Hokage. She later expressed skepticism toward Orochimaru's son Mitsuki but continued advising Konoha's leadership.