Indigofera tinctoria (Linn.), commonly known as true indigo, is a medicinal plant traditionally used in various ethnomedical systems, including Ayurveda, Traditional Chinese Medicine (TCM), and African traditional medicine. Beyond its historical role as a natural dye source, the plant has attracted increasing scientific interest due to its diverse pharmacological properties and bioactive constituents. This review aimed to systematically evaluate the ethnopharmacological uses, phytochemical composition, and pharmacological activities of I. tinctoria, while highlighting its potential for evidence-based therapeutic applications. A narrative review with a systematic literature search approach was conducted using electronic databases, including Scopus, PubMed, Web of Science, Google Scholar, and ScienceDirect. Relevant studies published between 2020 and 2026 were identified using keywords related to Indigofera tinctoria, ethnopharmacology, phytochemistry, and pharmacological activity. Study selection followed PRISMA guidelines, and a total of 45 eligible studies were included in the qualitative synthesis. The findings demonstrated that I. tinctoria has been traditionally utilized for the treatment of inflammatory disorders, skin diseases, infections, liver dysfunction, fever, and metabolic abnormalities. Phytochemical analyses revealed the presence of flavonoids, alkaloids, tannins, saponins, terpenoids, phenolic compounds, indigo, and indirubin, which contribute to its biological activities. Experimental studies reported significant anti-inflammatory, antioxidant, antimicrobial, hepatoprotective, antidiabetic, and immunomodulatory effects. Among the identified compounds, indirubin showed notable pharmacological potential due to its anti-inflammatory and antiproliferative properties. However, the current evidence remains predominantly based on in vitro and animal studies, while clinical validation in humans is still limited. In conclusion, Indigofera tinctoria possesses promising ethnopharmacological and therapeutic potential supported by growing scientific evidence. Nevertheless, further studies focusing on standardized phytochemical characterization, mechanistic investigations, toxicological assessments, and randomized clinical trials are necessary to facilitate its translation into evidence-based phytotherapeutic applications.
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