Bacterial therapies possess many unique mechanisms for treating cancer that are unachievable with standard methods. Bacteria can specifically target tumours, actively penetrate tissue, are easily detected and can controllably induce cytotoxicity. Over the past decade, Salmonella, Clostridium and other genera have been shown to control tumour growth and promote survival in animal models. In this Innovation article I propose that synthetic biology techniques can be used to solve many of the key challenges that are associated with bacterial therapies, such as toxicity, stability and efficiency, and can be used to tune their beneficial features, allowing the engineering of 'perfect' cancer therapies.