After the Fourth Shinobi World War, Tsunade supported Sakura's Therapy Center and prided herself to be her teacher. After Naruto became Hokage, Tsunade enjoys her days as a retired kunoichi but, at the same time, stays close to Konoha and aids the current leader when necessary. She's seen at the Five Kage Summit celebrated in Konoha alongside the retired Kage of her generation [34]. She's also known to snap at Boruto when he misbehaves [35]. Tsunade's natures include Lightning, Fire, Water, and Earth, as well as Yang [3] and in the anime Yin Release. [40] In the anime, she can make shadow clones and also shows proficiency in space–time ninjutsu and barrier ninjutsu. [41] Transformation Technique [ ]

Being Hokage comes with a heavy workload, especially in the aftermath of Orochimaru's Konoha Crush, which left the village understaffed. For this reason, when Tsunade is informed that Sasuke has defected to Orochimaru, Shikamaru Nara - only recently promoted to chūnin - is the highest ranking ninja she can assign to lead the Sasuke Recovery Team; she allows him any genin he can recruit for the mission, though recommends Naruto's inclusion. After the Recovery Team leaves, Tsunade is notified of the Konoha Special Mission Platoon's defeat by the Sound Four, Sasuke's escorts. Having already suspected that a team of genin wouldn't be enough, she requests Sunagakure's support so that Orochimaru, a mutual enemy of both villages, can't gain Sasuke's Sharingan. She is also informed that Lee, despite still recovering from his surgery, has also gone off to lend support.In the anime, Tsunade attended the memorial service for the fallen people of the Fourth Shinobi World War. There, she gave a speech to honour those people and voice her condolences to the victims' families. Tsunade was very willing to believe in the attainability of dreams while Nawaki and Dan were still alive, and that by supporting and encouraging those dreams she might be able to help achieve them. When both died gruesomely shortly after receiving her support, Tsunade lost faith in the idea of dreaming for anything, believing that the mere pursuit of it would be doomed from the outset. She becomes especially critical of those wanting to be Hokage, as both Dan and Nawaki died trying to attain the title and the past Hokage have all died prematurely and, as Tsunade argues, pointlessly because they held the position; she concludes that to be Hokage is a fool's job. [15]

Tsunade is very skilled in hand-to-hand combat, able to use chakra enhanced strength to cause severe damage to the enemy. This is achieved by rapidly concentrating chakra one part of the body and releasing it all at once, a feat that requires very advanced chakra control than that of medical ninjutsu. She teaches this ability to her disciple, Sakura Haruno. It's also possible to lift heavy weights using this enhanced strength, such as when Tsunade lifted Gamabunta's sword [23].Although Tsunade created the rules of medical ninjutsu, which abide that no medical-nin shall ever stand on the front lines, she is one of the few medical-nin that can participate in fights due to Creation Rebirth, a technique created by herself that allows her to regenerate and survive any injury that she receives in battle.