Pracaxi (Penthaclethra macroloba (Willd.) Kuntze) is an Amazonian plant, traditionally used by the native population to treat health disorders such as inflammation, erysipelas, wound healing, muscle pain, ear pain, diarrhea, snake and insect bites as well as for cancer treatment. Other common uses include using the oil for frying, skin and hair beautification, and as an alternative source of energy. This review is focused on highlighting its taxonomy, occurrence and botanical origins, popular uses, pharmacology and biological activities, cytotoxicity, biofuel activity and phytochemistry in order to explore future therapeutic use and other applications. Pracaxi contains triterpene saponins, sterols, tannins, oleanolic acid, unsaturated fatty acids and long-chain fatty acids, with a high behenic acid value, which may serve for incorporation into drug delivery systems as well for the development of new drugs. These components are correlated with its anti-inflammatory, antimicrobial, healing, anti-hemolytic, anti-hemorrhagic, antiophidic, and larvicidal activities against Aedes aegypti and Helicorverpa zea, which ratify the popular/traditional uses. The species is nitrogen fixing; it is easy to propagate in floodplains and the terra firma, and it can be used for the reforestation of degraded areas. Additionally, the oil extracted from the seeds can leverage the bioeconomy of the region based on sustainable exploration.