<p>Sago palm (<i>Metroxylon sagu</i> Rottb.) is a starch-producing plant with considerable potential for enhancing food security and sustainable development, particularly in Southeast Asia. Despite its high yield and adaptability to marginal environments, the crop remains underutilized. This review aims to provide a comprehensive synthesis of current knowledge surrounding <i>M. sagu</i>, including its taxonomy, morphology, cultivation, traditional and modern starch extraction methods, nutritional and phytochemical profiles, and industrial applications. A narrative review methodology was adopted, drawing upon peer-reviewed literature, ethnobotanical sources, and scientific databases to collate and classify relevant information. The findings highlight <i>M. sagu</i>’s functional starch characteristics, including high amylose and resistant starch content, which support its role in low-glycemic and prebiotic diets. Traditional uses such as ambuyat and region-specific dishes underscore its cultural significance, while modern industrial applications span biodegradable materials, bioethanol production, and pharmaceutical formulations. Comparative assessments with crops like cassava and breadfruit affirm sago’s nutritional viability and climate resilience. However, technological gaps remain in processing efficiency, clinical validation, and biotechnological improvement. In conclusion, <i>M. sagu</i> emerges as a versatile and sustainable carbohydrate source with multidimensional benefits for health, environment, and regional economies. Future research should focus on refining extraction technologies, validating health effects, and improving yield through breeding, thereby unlocking the plant’s global potential. Limitations include the narrative scope and reliance on secondary data, which future empirical studies should address.</p>