Fluoroquinolones, a widely used class of antibiotics, inhibit bacterial nucleic acid synthesis by targeting topoisomerase IV and DNA gyrase. While effective in treating bacterial infections, their overuse has led to microbial resistance, reducing their efficacy. Additionally, fluoroquinolones have numerous clinically significant side effects, including psychosis, confusion, seizures, headaches, dizziness, nausea, tendinitis, myopathy, depression, fatigue, and cardiovascular issues such as increased risk of aortic aneurysm, aortic dissection, and QT interval prolongation. The article reviews the neurological, cardiovascular, musculoskeletal, and endocrine side effects of fluoroquinolones, emphasizing the importance of understanding these complications to determine the risks and benefits for clinicians. It highlights specific drugs like ciprofloxacin and its potential to cause neurotoxicity, peripheral neuropathy, and hypoglycemia. The FDA has issued warnings about the risks associated with fluoroquinolones, particularly in patients with pre-existing conditions or those at higher risk for adverse events. The article also discusses the mechanisms behind these side effects and the need for caution in prescribing fluoroquinolones, especially when alternative treatments are available.Fluoroquinolones, a widely used class of antibiotics, inhibit bacterial nucleic acid synthesis by targeting topoisomerase IV and DNA gyrase. While effective in treating bacterial infections, their overuse has led to microbial resistance, reducing their efficacy. Additionally, fluoroquinolones have numerous clinically significant side effects, including psychosis, confusion, seizures, headaches, dizziness, nausea, tendinitis, myopathy, depression, fatigue, and cardiovascular issues such as increased risk of aortic aneurysm, aortic dissection, and QT interval prolongation. The article reviews the neurological, cardiovascular, musculoskeletal, and endocrine side effects of fluoroquinolones, emphasizing the importance of understanding these complications to determine the risks and benefits for clinicians. It highlights specific drugs like ciprofloxacin and its potential to cause neurotoxicity, peripheral neuropathy, and hypoglycemia. The FDA has issued warnings about the risks associated with fluoroquinolones, particularly in patients with pre-existing conditions or those at higher risk for adverse events. The article also discusses the mechanisms behind these side effects and the need for caution in prescribing fluoroquinolones, especially when alternative treatments are available.