Van Niekerk, who has qualified in the men’s 200m, says his decision will depend on how he performs in both his individual race and the 4x400m relay.
Since suffering a knee injury during a social touch rugby game a few years ago, the 33-year-old has struggled to return to the same form that earned him two world championship medals and an Olympic gold in 2016.
Van Niekerk says he will weigh up what is most important for him and decide on his future after the championships.
“And if the performances are there and the body is healthy, I might just give it another go but at the same time, I think I just have to check what my priorities look like and then go from there."
The two-time world champion, who claimed medals in Beijing 2015 and London 2017, says he is fit, motivated, and eager to deliver strong performances in Tokyo as he looks to approach the championships step by step.
"The expectations as a team, we have a big desire to get ourselves amongst the medals for the 4x400m. So, that is really something I wanted to be a part of for a very long time now,” he added.
“Health is looking good, body has been responding well, so and then my only individual event at 200m, it's been years waiting to be in good shape, competing in the 200m.
“I think I saw that I've ran one of my fastest times ever in the 200m. Going off of my last performance, I would say it is positive in a good space and place, obviously not close to medal contention quite yet, I have to be realistic but at the same time, I think we are taking it step by step."