Methotrexate (MTX) is a metabolite that functions as an antifolate, impeding DNA synthesis, repair, and cell replication. Its clinical uses include rheumatoid arthritis treatment and cancer treatments due to its anti-folate mechanism of action. This medication serves as the primary disease-modifying antirheumatic drug (DMARD) for individuals afflicted with dermatological, inflammatory, and autoimmune conditions. Methotrexate has a unique mode of action, both in terms of its usage as a chemotherapeutic drug and as an immunosuppressant, in the management of autoimmune disorders. It can be combined with anti-TNF (Tumour Necrosis Factor) drugs and used as an off-label treatment for graft-versus-host disease. However, there are limitations to its usage, such as increased toxicity problems and brief plasma life. Methotrexate can be used as a nano-drug to decrease administration frequency while maximizing pharmacological effects and minimizing systemic side effects. The utilization of nanodrugs has been found to be more efficacious in comparison to intra-articular or oral delivery methods. Additionally, it has been determined that the co-loading of MTX-SPIONs (Superparamagnetic iron oxide nanoparticles) in NLC (Nanostructured lipid carriers) has been found to be a viable carrier for the delivery of MTX. The present review focuses on potential effects of methotrexate on health.