Agave syrup (AS), a food product made from agave plant sap, is a vegan sweetener that has become popular for replacing conventional sweeteners such as sucrose. As the demand for naturally derived sweeteners has grown in the last decade, this review paper addresses and discusses, in detail, the most relevant aspects of the chemical AS analysis, applications in the food industry, sustainability issues, safety and quality control and, finally, nutritional profile and health impacts. According to our main research outcome, we can assume that the mid-infrared-principal components analysis, high-performance anion exchange chromatography equipped with a pulsed amperometric detector, and thin-layer chromatography can be used to identify and distinguish syrups from natural sources. The main agave–derived products are juice, leaves, bagasse, and fiber. In sustainability terms, it can be stated that certified organic and free trade agave products are the most sustainable options available on the market because they guarantee products being created without pesticides and according to specific labor standards. The Mexican government and AS producers have also established Mexican guidelines which prohibit using any ingredient, sugar or food additive that derives from sources, apart from agave plants, to produce any commercial AS. Due to its nutritional value, AS is a good source of minerals, vitamins and polyphenols compared to other traditional sweeteners. However, further research into the effects of AS on human metabolism is necessary to back its health claims as a natural sugar substitute.