Oxandrolone is an anabolic steroid derived from testosterone with no toxicity, prevalently used for burned lesions in children or with short stature and delayed puberty. Oxandrolone increases protein synthesis in muscle and other tissues for its metabolic effects. It seems suitable for patients with sarcopenia, cachexia, and other chronic diseases such as heart failure, liver disease, osteoporosis, and neurodegenerative diseases. In menopausal women, oxandrolone reduces the side effects due to low estrogen levels. The effect of oxandrolone in osteoporosis in men and women is related to its activation of androgen receptors (AR) directly and after aromatization on estrogen receptors (ER). In neurodegenerative diseases, the efficacy of oxandrolone is related to the capability to stimulate myelin regeneration in central and peripheral nerves. This review aims to consider the clinical effects of oxandrolone in men and women. Considering that this molecule was synthesized many years ago and given the low cost, no clinical research has been conducted by the pharmaceutical industry, and the clinical interest in this drug has fallen.