Tranexamic acid (TXA), primarily an antifibrinolytic agent, has shown expanding applications in dermatology following its serendipitous discovery in treating melasma. Further, its anti-inflammatory and vasoconstrictive properties have led to its exploration in various other dermatological conditions. TXA has demonstrated efficacy in treating multiple conditions including acne vulgaris, post-acne erythema, Riehl’s melanosis, macular amyloidosis, lichen planus pigmentosus, telangiectasia, rosacea, and various types of hyperpigmentation. Besides, its contribution in urticaria and angioedema cannot be undermined. Today, TXA has emerged as a versatile therapeutic option in dermatology, offering multiple administration routes and a good safety profile. While initial results are promising across various conditions, additional well-designed studies are needed to establish standardized treatment protocols.