The hippocampus, a critical brain region for learning and memory, is particularly vulnerable to damage in the early stages of Alzheimer's disease (AD). Recent evidence suggests that altered neurogenesis in the adult hippocampus is an early and critical event in AD progression. Key molecules involved in AD pathogenesis, such as ApoE, PS1, APP, and their metabolites, impact new neuron generation, either positively or negatively. Neurogenesis plays a crucial role in structural plasticity and network maintenance, and dysfunctional neurogenesis can exacerbate neuronal vulnerability to AD, contributing to memory impairment. Enhanced neurogenesis may serve as a compensatory mechanism and an endogenous brain repair strategy. This review discusses recent findings on alterations in neurogenesis associated with AD pathogenesis and explores the potential of neurogenesis-based diagnostics and therapeutic strategies for AD. Environmental enrichment and physical activity have been shown to improve cognitive performance and enhance neurogenesis in AD mouse models, suggesting that these factors may play a role in disease management. Understanding the molecular mechanisms underlying neurogenesis in AD could provide new insights into early diagnosis and treatment strategies.The hippocampus, a critical brain region for learning and memory, is particularly vulnerable to damage in the early stages of Alzheimer's disease (AD). Recent evidence suggests that altered neurogenesis in the adult hippocampus is an early and critical event in AD progression. Key molecules involved in AD pathogenesis, such as ApoE, PS1, APP, and their metabolites, impact new neuron generation, either positively or negatively. Neurogenesis plays a crucial role in structural plasticity and network maintenance, and dysfunctional neurogenesis can exacerbate neuronal vulnerability to AD, contributing to memory impairment. Enhanced neurogenesis may serve as a compensatory mechanism and an endogenous brain repair strategy. This review discusses recent findings on alterations in neurogenesis associated with AD pathogenesis and explores the potential of neurogenesis-based diagnostics and therapeutic strategies for AD. Environmental enrichment and physical activity have been shown to improve cognitive performance and enhance neurogenesis in AD mouse models, suggesting that these factors may play a role in disease management. Understanding the molecular mechanisms underlying neurogenesis in AD could provide new insights into early diagnosis and treatment strategies.