Silkworm pupae are insects that are beneficial to human health, not only for their high nutritional value but, more importantly, for the variety of pharmacological functions they can perform when consumed. Currently, there is a lot of interest in the pharmaceutical applications of silkworm pupae. In recent years, the biological functions of domestic silkworm pupae have gradually been identified and confirmed, especially for their beneficial effects on human health. Studies have found that silkworm pupae have positive effects on liver protection, immune enhancement, antiapoptosis, antitumour, antibacterial, regulation of blood glucose and blood lipids, and lowering of blood pressure. However, the pharmacological mechanisms and systemic safety of silkworm pupae have not been systematically evaluated. In this paper, the nutritional composition of the pupae of the domestic silkworm is first summarised. The pharmacological functions of silkworm pupae and their components are then classified, and their mechanisms of occurrence are described. In addition, we provide a preliminary evaluation of the safety of silkworm pupae, analyse their application prospects, and suggest future directions for further pharmacological function studies. The aim is to generate interest in the promotion of human health through the use of silkworm pupae.