Moringa oleifera, a rapidly growing tree native to tropical and subtropical regions, has gained significant attention for its diverse applications in nutrition, biogas production, and as a fertilizer. Its resilience to drought conditions further enhances its value. The plant's remarkable adaptability and widespread distribution are reflected in collaborative research efforts involving scientists from various countries globally. This review delves into the multifaceted nature of M. oleifera, aiming to consolidate the existing knowledge regarding its ethnomedicinal uses, pharmacological properties, and chemical composition, while also identifying gaps in current research and proposing future research directions. The significance of this study lies in the potential of M. oleifera to serve as a sustainable and readily available resource for addressing various health and agricultural challenges worldwide. Its remarkable versatility across diverse sectors necessitates a comprehensive understanding of its benefits and limitations. This review focuses on presenting a detailed account of the various aspects of M. oleifera, encompassing its taxonomy, morphology, distribution, traditional applications, pharmacological activities, phytochemical profile, pharmaceutical formulations, clinical trials, toxicity assessments, and miscellaneous uses. By synthesizing information from a vast array of scientific literature, this comprehensive approach contributes to a more complete understanding of the ‘miracle tree’ and its potential to significantly impact various fields.

Extensive literature on Moringa oleifera, dating back several decades, encompasses diverse aspects of the plant, including its botany, traditional uses, nutritional value, and various biological activities. A significant portion of the existing literature focuses on the plant's ethnomedicinal properties, highlighting its traditional applications in different cultures. These traditional uses have served as a foundation for numerous scientific investigations that aimed to validate the pharmacological activities. Furthermore, a considerable body of research is dedicated to the plant's phytochemistry, aiming to isolate and identify bioactive compounds responsible for its therapeutic effects. While much research focuses on preclinical studies (in vitro and in vivo models), a growing number of clinical trials are investigating the plant's efficacy in treating various diseases, demonstrating a progression from ethnobotanical observations to evidence-based medical applications. Finally, numerous studies focus on the various formulations derived from M. oleifera, exploring the development of stable and effective products for commercial use. The review synthesizes information from diverse publications focusing on various aspects of Moringa oleifera. The references included reflect a broad range of research methodologies, including experimental, analytical, and clinical studies.

This review employed a systematic approach to gather and synthesize information from a vast body of literature pertaining to Moringa oleifera. The search encompassed several databases, including PubMed, Scopus, Web of Science, and Google Scholar, utilizing relevant keywords such as ‘Moringa oleifera,’ ‘ethnopharmacology,’ ‘pharmacology,’ ‘phytochemistry,’ ‘therapeutic applications,’ ‘toxicity,’ and ‘formulations.’ The search was not limited to a specific time period, enabling the inclusion of both historical and recent publications, thereby providing a comprehensive understanding of the evolution of research on this plant. Inclusion criteria involved peer-reviewed articles written in English language that provided data regarding the different aspects of M. oleifera. Exclusion criteria were studies conducted in languages other than English, review articles without experimental data, and studies with no relevant information to the scope of the review. The gathered data was meticulously organized and analyzed, focusing on the various pharmacological activities, phytochemicals, formulations, toxicity aspects, and traditional uses of the plant. The data analysis was qualitative and quantitative, involving a critical appraisal of the methodological rigor of individual studies and an assessment of the overall consistency and weight of evidence. Data synthesis involved grouping studies based on similar themes, such as the anti-inflammatory or anticancer activities of the plant, and identifying trends and patterns in the findings. The synthesis also critically evaluated any inconsistencies between studies and explored potential reasons for such differences. The final manuscript was structured to present the collected information in a clear and comprehensive manner, enabling readers to easily understand the various aspects of Moringa oleifera research. Graphics were included to enhance visual understanding and improve readability.

This review revealed that Moringa oleifera possesses a remarkable array of biological activities, primarily attributed to its rich phytochemical profile. The plant contains numerous bioactive compounds, including alkaloids (e.g., moringin, moringinine, niazimicin), phenolic acids (e.g., caffeic acid, ferulic acid, chlorogenic acid), flavonoids (e.g., quercetin, kaempferol, rutin, myricetin), glucosinolates (e.g., glucomoringin), terpenes (e.g., phytol), and fatty acids (e.g., oleic acid, palmitic acid, arachidic acid). These compounds have been implicated in a wide spectrum of pharmacological actions, including anti-inflammatory, antioxidant, antimicrobial, anticancer, antidiabetic, antihypertensive, cardioprotective, hepatoprotective, neuroprotective, analgesic, antipyretic, and wound-healing activities. Several studies have demonstrated the efficacy of various M. oleifera extracts in preclinical models, and a growing number of clinical trials are confirming its therapeutic potential in humans. The plant has shown promise in treating conditions such as hypertension, diabetes, obesity, arthritis, cancer, and neuropathic pain. Its antimicrobial and antioxidant activities are also significant, suggesting potential applications in food preservation, wound healing, and other relevant fields. However, studies have also highlighted the potential toxicity of M. oleifera at high doses, particularly in terms of abortifacient effects. This necessitates further research to establish safe and effective dosages for therapeutic applications. The review extensively discusses the different formulations developed based on Moringa oleifera extracts, including ointments, creams, gels, tablets, films, and microparticles. These formulations aim to improve drug delivery, enhance bioavailability, and enhance patient compliance. The diverse applications of M. oleifera, beyond medicinal use, include its role as a biostimulant in agriculture and a water purifier. The plant's ability to enhance crop growth and improve water quality points to its significant potential in tackling agricultural challenges and improving sanitation in developing countries.

The findings of this comprehensive review confirm the significant therapeutic potential of Moringa oleifera, largely supported by a substantial body of preclinical and clinical evidence. The diverse range of biological activities exhibited by this plant can be directly linked to its rich phytochemical composition, highlighting the synergistic effects of its various bioactive compounds. The review also underscores the need for further research to fully understand the mechanisms of action behind these activities and to identify the optimal dosages for therapeutic efficacy. The presence of potential toxic effects at high doses necessitates a cautious approach to its clinical application. While preclinical studies provide encouraging results, more large-scale, well-designed clinical trials are needed to strengthen the evidence base for M. oleifera's efficacy and safety in treating specific diseases. This review also acknowledges the plant's applications beyond medicine, specifically within the agriculture sector, further highlighting its broader societal impact. Future studies should focus on standardizing extracts, optimizing formulations, and carrying out more clinical trials to establish the therapeutic efficacy and long-term safety of various M. oleifera preparations.

Moringa oleifera, often termed the ‘miracle tree,’ holds immense promise as a versatile resource for human health and agriculture. This review consolidates extensive research on its diverse pharmacological properties, phytochemical composition, various formulations, and traditional uses. While its potential benefits are numerous and supported by preclinical and clinical evidence, more clinical studies and mechanistic investigations are necessary to fully realize its therapeutic potential and establish safe and effective dosing regimens. Its application as a biostimulant in agriculture further expands its utility, showcasing the plant's broader impact beyond medicinal applications.

This review, while comprehensive, has limitations inherent to any literature-based synthesis. The available data may not always be consistent due to differences in study designs, methodologies, and the geographical origins of the plant material used in different experiments. The focus on English-language publications might have excluded relevant studies conducted in other languages. Furthermore, while numerous preclinical studies have demonstrated M. oleifera's therapeutic potential, the limited number of large-scale, high-quality clinical trials restricts the strength of evidence regarding its efficacy in treating specific human diseases. Finally, the potential for synergistic effects between different phytochemicals in Moringa oleifera is not fully understood.