Metformin is one of the safest drugs used to control blood sugar in diabetes. This drug is being investigated by orthopedists as well as by neurosurgeons as it may increase the locomotor recovery after spinal cord injury (SCI). In the present study, the aim was to evaluate a promising pharmacological agent, metformin, which is known to be used in SCI treatment by acting over the mammalian target of rapamycin (mTOR) and some other signaling pathway. Relevant clinical trials were included in the study following electronic database scan. Preclinical and cellular studies have demonstrated that metformin may have antitumoral properties, regulate inflammation, and therefore play a role in the tumor microenvironment, or that it has a therapeutic effect in SCI by acting over mTOR pathway. However, Level of I clinical trials should be performed to determine the effectiveness of metformin in SCI, a serious pathology.