Background: Astaxanthin is a high-value carotenoid with various applications, one of which is in biomedical science. Haematococcus pluvialis is considered the most promising source of natural astaxanthin as it can accumulate up to 5% of its dry weight under stressful conditions. Aim: This narrative review aims to provide a comprehensive synthesis of the biological properties, cultivation challenges, and therapeutic applications of astaxanthin from H. pluvialis in biomedical science. Methods: Articles were collected through searches of the PubMed, ScienceDirect, and Google Scholar databases using combinations of the keywords “astaxanthin,” “Haematococcus pluvialis,” “biomedical,” “cultivation,” and “therapeutic,” prioritising articles published between 2014 and 2024; relevant sources were selected narratively without a formal systematic review protocol. Results: Astaxanthin exhibits neuroprotective, anti-inflammatory, anti-cancer, and cardioprotective effects underpinned by its unique molecular structure and amphiphilic nature. Nevertheless, low bioavailability, high production costs, and the slow growth rate of H. pluvialis remain major obstacles to its clinical translation. Conclusion: Astaxanthin from H. pluvialis represents a multifunctional agent with significant clinical potential, warranting further studies to optimise its bioavailability and therapeutic efficacy.
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