Actovegin is a biological drug produced from deproteinised hemodialysate of calf serum with over 50 years of history for its clinical
use. There have been many in vitro studies to speculate its potential role and mechanism of action in cells; due to the nature of this drug and serum based culture techniques for most in vitro experiments, presumptuous conclusions and claims from these studies on performance enhancement should be cautiously interpreted. There have been well-designed human in vivo studies suggesting it does not enhance human performance, and has potentially good clinical applications to treat injuries, strokes and diabetes. Recently, evidence has emerged suggesting Actovegin has anti-inflammatory and anti-apoptotic effects on injured tissues; further clinical research is needed to define these effects. This article also provides a narrative review of Actovegin summarizing outcomes from recent publications