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**Medical ozone** is ozone gas (O3), typically generated immediately before use from medical oxygen and administered as an ozone/oxygen gas mixture. It is an investigational therapeutic gas used in heterogeneous clinical protocols, including intra-articular injection for knee osteoarthritis and rectal insufflation for chemotherapy-induced peripheral neuropathy. Ozone is a highly reactive oxidant rather than a selective receptor-directed drug; proposed biological effects involve rapid reactions with biological fluids and lipids that produce transient reactive oxygen species and lipid-oxidation products, potentially activating endogenous antioxidant and anti-inflammatory response pathways. Clinical evidence remains variable by indication, route, concentration, and treatment schedule. In the United States, ozone is not an FDA-approved therapeutic drug, and federal regulation states that ozone is a toxic gas with no known useful medical application in specific, adjunctive, or preventive therapy. ([pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/28738079/))
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