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The nervous system exhibits remarkable stability, making its repair challenging. Compared to the central nervous system, peripheral nerve injuries demonstrate a greater potential for regeneration. Schwann cells, the unique myelinating glial cells of the peripheral nervous system, possess striking plasticity and support nerve regeneration through phenotypic transformation following injury. While Schwann cells are essential for nerve regeneration after injury, in the context of tumors, their reparative function is exploited to facilitate perineural invasion and the progression of cancer. However, the tumor-promoting effect of Schwann cells is context-dependent, and emerging evidence suggests that under specific conditions, Schwann cells may exert tumor-suppressive functions. This article aims to explore the complex roles of Schwann cells in both physical nerve injury and tumor-induced nerve damage, comparing their similarities and differences and seeking to provide insights for future research and potential therapeutic interventions.