Tsunade is a fair-skinned woman with brown eyes and straight blonde hair that parts above her forehead. Her hair has shoulder-length bangs that frame her face and the rest reaches her lower back and keeps her hair in two ponytails. The Strength of a Hundred Seal - taking the appearance of a violet diamond- is clearly visible on her forehead.

Tsunade maintains her youthful appearance using a unique Transformation Technique. Tsunade often wears a grass-green haori with the kanji for "gamble" (賭, kake) on the back, inside a red circle. Underneath she wears a grey, kimono-style blouse with no sleeves, held closed by a broad, dark bluish-grey obi that matches her pants. Her blouse is closed quite low, revealing her sizable cleavage. She wears open-toed, strapped black sandals with high heels. She has red nail polish on both her fingernails and toenails and uses a soft pink lipstick.

Kaguya had used the God Tree to cast the Infinite Tsukuyomi on all the Shinobi that had gone to stop her. You are Naruto Uzumaki and as the Jutsu was cast, you managed to avoid its entrancing gaze, but everyone else wasn't so lucky. You look around and see all the Shinobi and your friends standing in place and staring off into space.

As you look at each of them, you see that they all have purple swirls filling their eyes. As you walked, you spotted Tsunade and ran over to her. You could see a blissful smile on her face as she stood there, staring into the distance

Tsunade: I… I knew you would become Hokage… Dan… she smiles, clearly dreaming that her old lover, Dan, never died and became Hokage of Konoha

Tsunade: Shizune… and I are so… proud… She continues smiling as she continues to dream