Tsunade is known by various titles such as the Fifth Hokage, the Legendary Sucker, and Konoha's Slug Princess. She is a noteworthy and captivating figure due to her exceptional abilities as the world's strongest kunoichi and greatest medical ninja. Furthermore, Tsunade is regarded as the granddaughter of the First Hokage, which grants her possession of his Necklace and bolsters her reputation as a prominent figure in the ninja world.