Tribulus terrestris L. (TT) is a plant used in traditional Chinese medicine, Ayurvedic medicine,
and sports nutrition to improve health and performance. However, no conclusive evidence exists
about the potential beneficial effects of TT on sport and health biomarkers in physically active
adults. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
guidelines, and the modified McMaster Critical Review Form for methodological quality assessment,
we systematically reviewed studies indexed in Web of Science, Scopus, and PubMed, to assess
the effects of TT on immunological, hematological, biochemical, renal, lipidic, hormonal behavior,
and anti-inflammatory response in physically active adult males. Among 340 records identified
in the search, a total of 7 studies met the inclusion and exclusion criteria. Overall, participants
supplemented with TT displayed significant improvements in lipid profile. Inflammatory and
hematological biomarkers showed moderate beneficial effects with no significant changes on renal
biomarkers. No positive effects were observed on the immune system response. Additionally, no
TT-induced toxicity was reported. In conclusion, there was no clear evidence of the beneficial effects
of TT supplementation on muscle damage markers and hormonal behavior. More studies are needed
to confirm the benefits of TT due to the limited number of studies available in the current literature.
