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[7]. 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.
As a field medical-nin, Tsunade is highly skilled in the art of evasion. This is to keep herself alive in battle so she may heal her team-mates; a skill she drilled into Sakura while training her. She is also able to quickly pick up on her opponent's fighting style and battle rhythm to better avoid damage and plan her battle strategy around that. 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[8], 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.
Additionally, Tsunade has showcased incredible durability, both physically and mentally. She was still able to move after having her muscles torn, something Kabuto himself found impressive and praise-worthy. Furthermore, after being stabbed straight through the chest, her left shoulder, and her abdomen, she survived the normally fatal damage and still managed to land an attack on Orochimaru.