This review aims to provide a comprehensive overview of both conventional and molecular studies focusing on acrocentric chromosome association/satellite association (ACA/SA) research for assessing human health conditions including cancer as well as in evaluating exposure to genotoxic agents. It is well documented that the ACA/SA frequency in lymphocytes of patients with oral squamous cell carcinoma and gastrointestinal and breast cancer has been evaluated by many workers. Literature was searched using various combinations of keywords in different databases. The articles that appeared till March 2023 were considered depending on their relevance, and relevant information was extracted by two independent reviewers. A total of 97 studies were selected based on our criteria describing the relevant keywords, 46 studies described SAs/acrocentric association with different diseases, 35 studies demonstrated effects of genotoxic agents, 8 studies were on characteristics and general aspects of ACA/SA phenomenon, and 8 studies described the molecular mechanisms of acrocentric chromosomes. Thus, ACA/SA was crucial in assessing human health conditions, including genetic disorders and cancer, as well as in evaluating exposure to genotoxic agents. The information collected would help to promote a deeper understanding of the impact of ACA/SA on human health including cancer and emphasize the importance of integrating molecular approaches into genotoxic exposure studies. Continued research in this field will undoubtedly contribute to the advancements in medical genetics and improved patient care.