In recent years, the application of engineered NMts has significantly contributed to various biomedical fields. ZnO NMts (ZnO NMts) are widely utilized due to their biocompatibility, unique physical and chemical properties, stability, and cost-effectiveness for large-scale production. They have emerged as potential materials for anti-cancer applications. This study aims to study the impact of ZnO Nanorod flowers (ZnO NRfs) and their combination with temozolomide (TMZ) on glioma cells. Normal mouse microglia (BV2) will be used as a control to assess the effects on mouse glioma cells (G422) and human glioma cells (LN229). The effects of these substances were evaluated on G422 and LN229 cells through various parameters such as IC50 value, Zn2+ accumulation, ROS production, apoptosis, mitochondrial membrane potential (MMP) depolarization, and examination of organelles like mitochondria and lysosomes. Additionally, hypoxia-inducible factor-1α (HIF-1α), endothelial cell PAS domain protein 1 (EPAS1), autophagy markers (LC3), mitophagy and phagocytosis marker (BNIP3) were assessed. The results demonstrated that the combination of ZnO NRfs and TMZ could influence the expression of HIF-1α, EPAS1, LC3, and BNIP3 proteins, leading to mitophagy in glioma cells. This combination treatment has the potential to effectively eliminate glioma cells by activating the mitophagy pathway, which provides a good prospect for the clinical treatment of glioma.