<![CDATA[Histological microscopic preparations are the gold standard for cancer diagnosis, with clearing being one of the essential steps. The clearing process aims to replace dehydrants, render tissues transparent, facilitate paraffin infiltration, and enhance staining quality. Xylene is commonly used as a clearing agent; however, it is known to be toxic, placing histopathology laboratory technicians at high risk of exposure. Exploration of natural alternatives has been pursued, including coconut oil. This study employed a literature review method using databases such as Google Scholar, ScienceDirect, PubMed, and Garuda. The search strategy followed the Population, Intervention, Comparison, Outcome (PICO) framework with the keywords “coconut oil” AND “clearing agent” AND “xylene” AND “histology.” Article selection was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. From 84 identified articles, nine experimental studies met the inclusion criteria, originating from India, Ghana, Nigeria, and Indonesia. Several factors influencing the clearing process were identified, including tissue size, section thickness, temperature, and immersion time. Most studies performed coconut oil incubation to reduce viscosity, optimizing the clearing effect. Macroscopic parameters evaluated included translucency, rigidity, shrinkage, and ease of sectioning. Specimens cleared with coconut oil exhibited lower translucency, softer consistency, minimal shrinkage, and greater ease of microtome sectioning. Microscopic parameters assessed were cellular structure and staining quality, with coconut oil demonstrating comparable staining outcomes to xylene. Therefore, coconut oil may serve as a potential natural clearing agent substitute for xylene in histological preparations. Keywords: Clearing agent, Macroscopic, Microscopic, Coconut oil, Xylene]]>
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