Nigella sativa, commonly known as black cumin, is a plant used in traditional medicine and cooking, particularly in the Middle East, South Asia, and parts of Europe. Its seeds contain thymoquinone (TQ), a bioactive compound with antioxidant, anti-inflammatory, anti-hypertensive, and hypoglycemic properties. This review discusses the potential mechanisms of action of Nigella sativa, the role of pharmaceutical technology in optimizing its preparations, and an analysis of the market for products containing Nigella sativa, with a focus on Italy. The plant has been studied for its effects on cardiometabolic diseases, including cardiovascular disease, diabetes, and metabolic disorders. Nigella sativa exhibits anti-oxidant, anti-inflammatory, and anti-diabetic activities, which may be attributed to TQ and other phytochemicals such as phytosterols, alkaloids, fatty acids, and polyphenols. Research indicates that Nigella sativa can improve lipid profiles, reduce blood pressure, and enhance insulin sensitivity. It also shows potential in treating obesity, dyslipidemia, and menopausal symptoms. However, the bioavailability of TQ is limited due to its poor solubility and stability, and efforts are being made to improve its delivery using nanotechnology. While Nigella sativa is generally considered safe, its long-term effects and toxicity require further investigation. Overall, Nigella sativa has shown promising therapeutic potential in various cardiometabolic conditions, but more research is needed to fully understand its mechanisms and optimize its use.Nigella sativa, commonly known as black cumin, is a plant used in traditional medicine and cooking, particularly in the Middle East, South Asia, and parts of Europe. Its seeds contain thymoquinone (TQ), a bioactive compound with antioxidant, anti-inflammatory, anti-hypertensive, and hypoglycemic properties. This review discusses the potential mechanisms of action of Nigella sativa, the role of pharmaceutical technology in optimizing its preparations, and an analysis of the market for products containing Nigella sativa, with a focus on Italy. The plant has been studied for its effects on cardiometabolic diseases, including cardiovascular disease, diabetes, and metabolic disorders. Nigella sativa exhibits anti-oxidant, anti-inflammatory, and anti-diabetic activities, which may be attributed to TQ and other phytochemicals such as phytosterols, alkaloids, fatty acids, and polyphenols. Research indicates that Nigella sativa can improve lipid profiles, reduce blood pressure, and enhance insulin sensitivity. It also shows potential in treating obesity, dyslipidemia, and menopausal symptoms. However, the bioavailability of TQ is limited due to its poor solubility and stability, and efforts are being made to improve its delivery using nanotechnology. While Nigella sativa is generally considered safe, its long-term effects and toxicity require further investigation. Overall, Nigella sativa has shown promising therapeutic potential in various cardiometabolic conditions, but more research is needed to fully understand its mechanisms and optimize its use.