Nipah virus (NiV) is a highly pathogenic zoonotic paramyxovirus that primarily affects humans and pigs, causing severe encephalitis and high mortality rates. The natural reservoir of NiV is the *Pteropus* bat species, which has a wide geographical distribution across Asia, Oceania, and Africa. Human outbreaks often occur when bats transmit the virus to humans through contaminated date palm sap, a practice common in Bangladesh. The virus has also been transmitted between humans through respiratory droplets and aerosols, as seen in outbreaks in Bangladesh and India. NiV infection is characterized by rapid progression to encephalitis, with a median mortality rate of 75%. Despite the high mortality, no therapeutic agents or vaccines are currently approved for human use. The article reviews the main determinants of NiV infection and potential therapeutic and preventive strategies. It highlights the importance of surveillance and outbreak detection, such as population-based surveillance systems and exposure-based screening, in early detection and control. Preventive measures include educational campaigns to reduce sap consumption and physical barriers during sap harvesting. Therapeutic agents under investigation include nucleoside/nucleotide analogs, monoclonal antibodies, and fusion-inhibitory peptides. The article emphasizes the need for low-cost, effective, and efficient preventive strategies in endemic regions, particularly in Bangladesh, to prevent the spread of NiV.Nipah virus (NiV) is a highly pathogenic zoonotic paramyxovirus that primarily affects humans and pigs, causing severe encephalitis and high mortality rates. The natural reservoir of NiV is the *Pteropus* bat species, which has a wide geographical distribution across Asia, Oceania, and Africa. Human outbreaks often occur when bats transmit the virus to humans through contaminated date palm sap, a practice common in Bangladesh. The virus has also been transmitted between humans through respiratory droplets and aerosols, as seen in outbreaks in Bangladesh and India. NiV infection is characterized by rapid progression to encephalitis, with a median mortality rate of 75%. Despite the high mortality, no therapeutic agents or vaccines are currently approved for human use. The article reviews the main determinants of NiV infection and potential therapeutic and preventive strategies. It highlights the importance of surveillance and outbreak detection, such as population-based surveillance systems and exposure-based screening, in early detection and control. Preventive measures include educational campaigns to reduce sap consumption and physical barriers during sap harvesting. Therapeutic agents under investigation include nucleoside/nucleotide analogs, monoclonal antibodies, and fusion-inhibitory peptides. The article emphasizes the need for low-cost, effective, and efficient preventive strategies in endemic regions, particularly in Bangladesh, to prevent the spread of NiV.