Descended from Konohagakure's founding clans through Hashirama Senju and Mito Uzumaki, Tsunade inherited the title "Princess" along with immense chakra reserves, physical energy, and life force. She graduated from the Ninja Academy at six and joined a team with Jiraiya and Orochimaru under Third Hokage Hiruzen Sarutobi. Their survival against Amegakure's Hanzō during the Second Shinobi World War earned them the moniker "Konoha's Legendary Sannin." Tragedy struck when her younger brother Nawaki, aspiring to be Hokage, died in battle the day after his twelfth birthday, shortly after receiving Hashirama's necklace from Tsunade. Later, her lover Dan Katō, harboring similar ambitions, succumbed to injuries she couldn't heal. These losses triggered severe hemophobia and convinced her the necklace was cursed while dismissing the Hokage role as a "fool's job." She championed mandatory medical-nin in all squads to prevent such deaths, a proposal rejected due to wartime needs. Following Dan's death, she departed Konoha with her apprentice Shizune, abandoning active shinobi duty. Decades later, Jiraiya and Naruto Uzumaki sought Tsunade to become Fifth Hokage after Hiruzen's death. She initially refused, deeming the title meaningless, and considered Orochimaru's offer to resurrect Dan and Nawaki in exchange for healing his arms. Witnessing Naruto's determination to become Hokage and his Rasengan mastery, however, rekindled memories of her loved ones' dreams. She rejected Orochimaru, overcame her hemophobia in battle, and accepted the Hokage role to protect Naruto and the village, giving Hashirama's necklace to Naruto as a symbol of faith in his future. As Fifth Hokage, Tsunade enacted systemic reforms: establishing advanced medical facilities and training, and revising combat protocols to require medical-nin develop offensive capabilities for self-defense. Her exceptional chakra control allowed her to store vast reserves in the Strength of a Hundred Seal on her forehead, fueling techniques like Mitotic Regeneration for near-instantaneous healing. She imparted these medical and combat methods to her student, Sakura Haruno. During Pain's assault, Tsunade defended Naruto's right to fight for Konoha against advisors who saw him only as a weapon. She summoned the slug Katsuyu, channeling her chakra through thousands of its clones to heal the entire village simultaneously, an act that exhausted her chakra and induced a coma. She later attended the Five Kage Summit, forming the Allied Shinobi Forces against Akatsuki. In the Fourth Shinobi World War, she battled Madara Uchiha alongside other Kage, sustaining critical injuries yet healing allies even while bisected. She survived and remained Hokage until succeeded by Kakashi Hatake. Tsunade maintains a youthful appearance via a specialized Transformation Technique sustained by chakra, reverting to her natural aged state when depleted. She wields immense physical strength, augmenting strikes with precise chakra bursts capable of shattering terrain or defenses like Susano'o. Known for bluntness, she bears a gambling addiction with notoriously bad luck, earning the epithet "The Legendary Sucker," and consumes alcohol heavily. She remained devoted to Dan's memory despite Jiraiya's longstanding affection. After retirement, she expressed distrust towards Orochimaru's associates, opposing Mitsuki's presence in Konoha. She witnessed Naruto Uzumaki's inauguration as Seventh Hokage, fulfilling the dream once shared by Dan and Nawaki.