Kiwano (Cucumis metuliferus E. Meyer ex Naudin) is a neglected crop from the Cucurbitaceae family with recognized nutritional and medicinal properties, especially in African countries. This review describes the recent findings regarding the nutritional and phytochemical composition of kiwano, supporting the pharmacological properties of this versatile fruit and identifying opportunities for further research. Also, the potential economic valorization of kiwano is discussed, namely, as a source of bioactive compounds for functional food and nutraceutical applications, as well as for the active food packaging sector to extend the shelflife of packaged food. Overall, this chapter concluded that the nutritional value and functional properties, such as anticardiovascular, antidiabetic, antiulcer, antioxidant, anti-inflammatory, antimalarial, and antiviral properties associated to this crop, suggest its potential medicinal and pharmaceutical uses. Further studies should be conducted to isolate and identify the individual chemical constituents of kiwano and assess their biological efficacy. Also, the valorization of the underutilized kiwano parts (leaves, flowers, and roots) should be promoted in terms of health and waste management purposes.