Objective: This paper aims to provide a comprehensive review of the changing role of transforming growth factor-b (TGF-b) signaling in intervertebral disc (IVD) health and disease. Methods: A comprehensive literature search was performed using PubMed terms 'TGF-b' and 'IVD'. Results: TGF-b signaling is necessary for the development and growth of IVD, and can play a protective role in the restoration of IVD tissues by stimulating matrix synthesis, inhibiting matrix catabolism, inflammatory response and cell loss. However, excessive activation of TGF-b signaling is detrimental to the IVD, and inhibition of the aberrant TGF-b signaling can delay IVD degeneration. Conclusions: Activation of TGF-b signaling has a promising treatment prospect for IVD degeneration, while excessive activation of TGF-b signaling may contribute to the progression of IVD degeneration. Studies aimed at elucidating the changing role of TGF-b signaling in IVD at different pathophysiological stages and its specific molecular mechanisms are needed, and these studies will contribute to safe and effective TGF-b signaling-based treatments for IVD degeneration.