Apple gourd (Praecitrullus fistulosus), is recognized as an exceptional plant with essential constituents for human health, yet remains underutilized despite offering unique flavor and nutritional benefits. This chapter explores nutritive values, phytochemicals, and therapeutic benefits like anti-diabetic, antimicrobial, anticancer, and hepatoprotective activities. Post-harvest practices and value-added products from this gourd are also dealt in the chapter. The framework integrates nutritive value assessment, phytochemical profiling and integrated health benefits. Multidimensional therapeutic properties documentation including antioxidative mechanisms, antidiabetic potential, antimicrobial spectrum, anticancer and cytotoxic efficacy, immunomodulatory functions, hepatoprotective benefits, and miscellaneous disease-preventive effects are also described. Contemporary post-harvest management and preservation strategies, innovative value-added product development spanning ethnic cuisine applications, cutting-edge functional food formulations, bio-fortified food product integration, and exploratory novel product development opportunities with safety assessment and pharmacological consideration are also covered. It is suggested that apple gourd’s transformative potential in global nutritional security and functional food innovation can be effectively realized through strategic cultivation and product development initiatives discussed in the chapter.