Though publicly seen on television as a bright and cheery individual, Tsunade actually has a much less explosive personality in real life. She tends to be very dull and fades into the background in conversations, which gives her a feeling of loneliness, and though her loud and crazy sound is present, it is heavily repressed. Secretly, she wishes she could be in the spotlight with everybody else, but her negative mindset just won't allow it. She is easily frightened and spends a fair amount of her time anxious or in a depressed state. However, she has the drive within her to work towards escaping, which is her main goal as the Ultimate Demolition Expert.

Her voice should be mid to high pitched and dull. She is generally soft-spoken, but yells and cheers when losing her reservations or being in an excitable state.

By popular demand, the canon voice that she is most similar to is Chihiro Fujisaki. When momentarily loud, she sounds more like Miu Iruma.