Interleukin-1 (IL-1) is a potent pro-inflammatory cytokine that plays a crucial role in various inflammatory and autoimmune diseases. Blocking IL-1 activity has shown rapid and sustained reduction in disease severity, including reversal of inflammation-mediated damage to tissues such as sight, hearing, and organs. Three IL-1-targeted agents—anakinra, rilonacept, and canakinumab—have been approved for treating a range of conditions, and several other therapeutic approaches are in development. IL-1 is produced by two genes, $IL1A$ and $IL1B$, encoding IL-1α and IL-1β, respectively, both of which bind to the IL-1 receptor type 1 (IL-1RI). IL-1α is constitutively present in healthy cells and can be released during ischemic events, while IL-1β is produced by a limited number of cells and requires intracellular processing. IL-1-mediated inflammation is implicated in a wide range of diseases, including autoinflammatory syndromes, chronic inflammatory conditions, and acute-onset ischemic diseases. Therapeutic strategies targeting the IL-1 receptor or neutralizing IL-1β have demonstrated efficacy in clinical trials, with anakinra being the most widely used agent. Ongoing trials are evaluating the potential of IL-1 blockade in treating cardiovascular events, type 1 diabetes, and other chronic inflammatory conditions.Interleukin-1 (IL-1) is a potent pro-inflammatory cytokine that plays a crucial role in various inflammatory and autoimmune diseases. Blocking IL-1 activity has shown rapid and sustained reduction in disease severity, including reversal of inflammation-mediated damage to tissues such as sight, hearing, and organs. Three IL-1-targeted agents—anakinra, rilonacept, and canakinumab—have been approved for treating a range of conditions, and several other therapeutic approaches are in development. IL-1 is produced by two genes, $IL1A$ and $IL1B$, encoding IL-1α and IL-1β, respectively, both of which bind to the IL-1 receptor type 1 (IL-1RI). IL-1α is constitutively present in healthy cells and can be released during ischemic events, while IL-1β is produced by a limited number of cells and requires intracellular processing. IL-1-mediated inflammation is implicated in a wide range of diseases, including autoinflammatory syndromes, chronic inflammatory conditions, and acute-onset ischemic diseases. Therapeutic strategies targeting the IL-1 receptor or neutralizing IL-1β have demonstrated efficacy in clinical trials, with anakinra being the most widely used agent. Ongoing trials are evaluating the potential of IL-1 blockade in treating cardiovascular events, type 1 diabetes, and other chronic inflammatory conditions.