Reflex control of immunity, as described in this review, highlights the role of neural circuits in modulating immune responses. The inflammatory reflex, a key mechanism, involves afferent and efferent neural pathways that sense and respond to injury and infection. The afferent arc detects molecular signals from injury or infection, while the efferent arc, particularly the cholinergic anti-inflammatory pathway, modulates immune responses through the release of acetylcholine. This pathway is crucial for preventing excessive inflammation and tissue damage. The cholinergic anti-inflammatory pathway is mediated by α7nAChR, which inhibits pro-inflammatory cytokine production and helps maintain immune homeostasis. Neural circuits, including the vagus nerve, play a vital role in this process, with the vagus nerve transmitting signals to the brain to regulate immune responses. The review discusses the molecular mechanisms of the cholinergic anti-inflammatory pathway, the role of α7nAChR in immune cells, and the anatomical pathways involved. It also explores the therapeutic implications of targeting these neural circuits for inflammatory diseases. The review emphasizes the importance of understanding the neural control of immunity and how it integrates with other physiological systems to maintain homeostasis. The findings suggest that modulating the inflammatory reflex could offer new therapeutic strategies for treating inflammatory diseases. The review also discusses the clinical relevance of vagus nerve activity in regulating immune responses and the potential for using vagus nerve stimulation as a therapeutic approach. Overall, the review underscores the critical role of neural circuits in controlling immune responses and highlights the potential for developing new treatments based on this understanding.Reflex control of immunity, as described in this review, highlights the role of neural circuits in modulating immune responses. The inflammatory reflex, a key mechanism, involves afferent and efferent neural pathways that sense and respond to injury and infection. The afferent arc detects molecular signals from injury or infection, while the efferent arc, particularly the cholinergic anti-inflammatory pathway, modulates immune responses through the release of acetylcholine. This pathway is crucial for preventing excessive inflammation and tissue damage. The cholinergic anti-inflammatory pathway is mediated by α7nAChR, which inhibits pro-inflammatory cytokine production and helps maintain immune homeostasis. Neural circuits, including the vagus nerve, play a vital role in this process, with the vagus nerve transmitting signals to the brain to regulate immune responses. The review discusses the molecular mechanisms of the cholinergic anti-inflammatory pathway, the role of α7nAChR in immune cells, and the anatomical pathways involved. It also explores the therapeutic implications of targeting these neural circuits for inflammatory diseases. The review emphasizes the importance of understanding the neural control of immunity and how it integrates with other physiological systems to maintain homeostasis. The findings suggest that modulating the inflammatory reflex could offer new therapeutic strategies for treating inflammatory diseases. The review also discusses the clinical relevance of vagus nerve activity in regulating immune responses and the potential for using vagus nerve stimulation as a therapeutic approach. Overall, the review underscores the critical role of neural circuits in controlling immune responses and highlights the potential for developing new treatments based on this understanding.