The review outlines the current understandings of saponins and sapogenins in agave species with special focus on pharmacological role of hecogenin in numerous preclinical studies. A systematic literature survey was done on the pharmacological activities of hecogenin during the past 40 y with electronic databases like PubMed, Science Direct, Wiley, SciFinder, Google Scholar, Web of Science and Scopus. Hecogenin, a steroidal sapogenin found abundantly in the leaves of Agave genus species such as, Agave sisalana, Agave cantala, Agave aurea and many more. This phytosteroid (hecogenin) is used as initial material for the synthesis of steroidal drugs in the pharmaceutical industry. Hecogenin has exhibited potential role in the management of a number of disorders such as inflammation, arthritis, cancer, gastric ulcer, cardiotonic and larvicidal activity. In this review, we have summarized the saponins and sapogenins present in the Agave species and pharmacological roles of hecogenin with their mechanism of action.