<p>This study investigated the restorative effects of dietary artichoke (<i>Cynara scolymus</i>) leaf extract (ALE) on growth performance, hemato-biochemical parameters, oxidative stress status, and histopathological alterations in Nile tilapia (<i>Oreochromis niloticus</i>) following sublethal deltamethrin (DM) exposure. A total of 186 fish were assigned to a two-phase experimental design: an exposure phase (21&#xa0;days) with waterborne deltamethrin (DM) at 1/20 of the 96-h LC₅₀ (0.0011&#xa0;mg/L) and a recovery phase (30&#xa0;days) during which fish were fed either a basal diet or a 2%-ALE-supplemented diet in clean water. At the end of Phase I, DM exposure markedly reduced growth performance (weight gain and specific growth rate) and feed efficiency, while inducing severe anemia, characterized by decreased red blood cell counts and hemoglobin levels (<i>P</i> &lt; 0.05). Furthermore, DM triggered pronounced hepatotoxicity and oxidative stress, evidenced by elevated serum transaminases (AST, ALT), alkaline phosphatase (ALP), malondialdehyde (MDA), and total oxidant status (TOS), alongside severe histopathological lesions in the gills, liver, and kidneys. During Phase II, spontaneous recovery in clean water was found to be insufficient for full physiological restoration. In contrast, dietary ALE supplementation notably accelerated the recovery process, effectively normalizing hemato-biochemical indices and reducing oxidative damage. ALE supplementation significantly improved growth and tissue repair compared to spontaneous recovery (<i>P</i> &lt; 0.05). These results suggest that dietary artichoke leaf extract is a potent restorative agent that can mitigate deltamethrin (a pyrethroid)-induced toxicity and enhance the physiological resilience of Nile tilapia in intensive aquaculture systems.</p>