Insulin-like Growth Factor 1 (IGF-1), also known as Somatomedin C and Mecasermin, is an endogenous peptide hormone primarily produced in the liver, although it is also synthesized in other tissues. It belongs to the growth factor category and shares structural similarity with insulin. IGF-1 plays a crucial role in growth and development, acting as a mediator of growth hormone (GH) effects. Researchers have extensively studied IGF-1 for its involvement in various physiological processes and diseases, including cancer, muscle hypertrophy, and cardiovascular health. IGF-1 is pivotal in regulating glucose metabolism, particularly in colorectal cancer, where it influences the Warburg effect. It also plays a significant role in skeletal muscle hypertrophy by modulating anabolic and catabolic pathways, and it has been observed to reduce coronary atherosclerosis in animal models. Mechanistically, IGF-1 exerts its effects through the IGF-1 receptor (IGF-1R), activating signaling pathways such as PI3K/Akt/mTOR and MAPK, which are involved in cell growth, survival, and metabolism. These pathways also intersect with glucose transport and glycolysis, impacting cancer cell metabolism and muscle protein synthesis. Pharmacokinetically, IGF-1 has a circulating half-life of approximately 12-15 hours when bound to its binding proteins, which extend its stability in the bloodstream. It is metabolized primarily in the liver and excreted by the kidneys. Clinically, IGF-1 is used in the treatment of growth failure in children with severe primary IGF-1 deficiency. It is regulated as a prescription medication and is prohibited in sports by the World Anti-Doping Agency due to its performance-enhancing potential.