Azadirachta indica A. juss, commonly known as known as Neem, has proven to be a miracle herb since the Vedic era in India. Neem is beneficial for both short term and long term use and its effectiveness has been validated from its utility in the traditional folk medicine. Extensive studies have focused on its biological, pharmacogenetic, pharmacokinetic and cosmetic aspects but complete description of its benefits, usage, safety measures and clinical toxicity still remains to be identified. Neem has been a powerful antimicrobial agent but its other inherent features makes it important as a diuretic, hypoglycemic and hepatologic agent. Its efficacy for cancer treatment is still unexplored. This review highlights the structural features of this wonder plant along with its history, ecology, compositional aspects, its formulations and major applications in therapy and medicine.