Alsophila nilgirensis (Holttum) R.M. Tryon, formerly known as Cyathea nilgirensis Holttum, is an endemic tree fern of the Western Ghats of southern India with reported ethnomedicinal significance and emerging pharmacological potential. Traditionally, the plant has been used in indigenous healthcare practices, particularly in the management of diabetes. This review consolidates the available literature on its ethnomedicinal applications, phytochemical constituents, pharmacological properties, and conservation concerns. Particular attention is given to the reported presence of phenolic compounds, flavonoids, and tannins, as well as the application of chromatographic techniques, including high-performance thin-layer chromatography (HPTLC), for phytochemical profiling. Preliminary pharmacological investigations, particularly studies involving antidiabetic, antioxidant, and antimicrobial activities, indicate that the species merits further scientific investigation. However, the existing evidence remains limited, and the biological activities of crude extracts cannot be attributed to individual phytochemicals without further experimental validation. The species' conservation status also highlights the need to integrate biodiversity conservation with responsible bioprospecting. Future research should focus on comprehensive phytochemical characterization, isolation and structural elucidation of bioactive compounds, mechanistic investigations, toxicity assessment, and rigorous validation of traditional medicinal claims through standardized experimental studies. Sustainable cultivation and conservation strategies are equally important to safeguard this threatened tree fern. This review identifies the current knowledge gaps and emphasizes the potential of A. nilgirensis as a subject for future research in ethnobotany, natural-product chemistry, and pharmacology.