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Neem extract is a complex bioactive mixture derived from the leaves, seeds, or bark of the *Azadirachta indica* tree, commonly known as the neem tree. It contains a diverse array of phytochemicals, including limonoids such as azadirachtin, nimbolide, and nimbin, which impart potent antimicrobial, anti-inflammatory, and antioxidant properties. Clinically, it is extensively investigated in dentistry as a mouthwash or gel for treating gingivitis, periodontitis, and dental plaque due to its ability to inhibit pathogens like *Streptococcus mutans* and *Enterococcus faecalis*. Beyond oral health, neem extract is explored for its potential to reduce viral load in COVID-19, treat arsenical palmar keratosis, and manage inflammatory conditions like acute hepatitis. Its mechanism of action involves the downregulation of pro-inflammatory signaling pathways such as NF-κB and the NLRP3 inflammasome, while simultaneously promoting protective cellular processes like autophagy.
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