Optimization and selection of antibodies, linkers, and payloads has helped fuel accelerated ADC development. Ideal antibody characteristics include selective binding and high affinity for the target antigen, a long half-life, low immunogenicity, and superior linker binding. Currently, ADCs widely use the immunoglobulin G1 antibody. Recent advances in antibody engineering research has offered new alternatives and include bispecific and trispecific antibodies targeting two and three distinct antigens 108 and also nanobodies, single domain antibody fragments. The linker moiety of an ADC should be stable in plasma, not alter the characteristics of the antibody or drug, be hydrophilic to mitigate lipophilic payload solubility effects, and release the payload selectivity and completely. They are divided into two major classes, cleavable and non-cleavable with cleavable linkers dominating both approved ADCs and ADCs currently in clinical trials. Lastly, the payload used for ADCs must also be stable in both blood and plasma and needs to be highly potent in small doses due to their selective release. A range of payloads are currently being used in approved ADCs including suristatins, calicheamicin, duocarmycins, maytansinoids, and pyrrolobenzodiazepines, with payloads such as amberstatin, eribulin, and tubulysin currently researched in clinical trials. Over 150 unique ADC candidates are being researched in clinical trials with their most utilized target antigens being HER2, followed by TROP2, Claudin 18.2, cMET, and B7H3, respectively. Eight unique bispecific ADCs have also entered clinical trials for th e treatment of various solid tumors. Among the various payloads utilized, topoisomerase I inhibitors, which impact DNA replication in cancer cells, are currently utilized by over 40 ADC candidates in clinical trials. Fifteen ADCs have gained regulatory approval across a wide range of cancer types including solid tumors such as breast, gastric and ovarian as well as hematologic malignancies such as lymphoma and leukemia. Table showcases a few promising regulatory approved ADCs to highlight the diversity amongst target antigens, disease indications, companies, and regulatory approval dates.