Abstract The use of ivermectin for the treatment of COVID-19 infections has been a subject of significant interest and controversy. The drug has a history of off-label use for a variety of clinical disorders and has shown some potential as an antiviral drug in in vitro studies and animal studies, and it has a relatively favorable safety profile. Multiple studies have been published examining the use of ivermectin against COVID-19. While several studies suggested it could be an effective therapeutic, most of these studies were insufficiently robust, had design flaws, or did not report any changes in important clinical outcomes, such as mortality. A smaller number of more robust studies did not support ivermectin use for COVID-19 treatment. Therefore, at present, ivermectin cannot be recommended for the treatment of COVID-19. While further studies may be warranted, this decision must be weighed against the possibility that this research may not alter current recommendations on the use of ivermectin in COVID-19 infections.    Keywords: COVID-19; ivermectin; prophylaxis, hospitalization, respiratory failure, mortality