Background: Earthworms, beyond being farmers’ friend, has been utilized in the maintenance of human health. Extracts from these animals offer alternatives to the treatment of many conditions where chemotherapy has not offered optimum protection without the usual side effects. It therefore becomes necessary to reorganize the roles this all-important specie could play in the provision and maintenance of public health. Objective: This study aims at showcasing how different molecules present in earthworms could be of value in keeping a healthy population in therapeutics and prophylaxis. Methods: A search of the relevant original research and review publications on the therapeutic effects of earthworms, mostly published between 2012 and 2022 in Google Scholar and PubMed using relevant words, was conducted. A total of 95 articles published in English were selected. Results: Records available showed that earthworms processed in the forms of crude extracts or bioactive compounds provided ethno-medical solutions to various ailments of humans, plants, and animals, including: antimicrobial, anti-inflammatory, antioxidant, anticoagulative, neuro-regenerative, antihyperlipidemic, antidiabetic, antihypertensive, anticancer, antiaging, and many other medical and agricultural benefits. Conclusion: Information available in literature shows that, at optimum form, temperature, dosage, and usage, earthworms can provide cost cost-effective alternative treatment to many ailments with the advantage of having negligible side effects. This calls for rigorous research and more clinical trial efforts in this direction to validate their therapeutic potentials, thereby improving public health, agricultural, and economic benefits obtainable from earthworms, especially in developing economies.