Escitalopram is a drug originally approved treatment of major depressive disorders (MDD). In the pharmacotherapy of obsessive compulsive disorders (OCD), general anxiety disorder (GAD) and post-traumatic stress disorder (PSTD), escitalopram may be considered a first-line treatment due to its good tolerability and lack of withdrawal symptoms. However, aside approved uses of escitalopram, the drug has found clinically-evidence-based uses for which it was not originally recognized. The objective of this review was to evaluate the unapproved uses of escitalopram in medicine. Electronic searches for relevant literature were undertaken in Google scholar, MEDLINE, EMBASE, PubMed, and Science Direct. Literatures and studies were considered in which escitalopram uses, facts about clinical uses of escitalopram, off-label uses, and limitations of the off-label uses were discussed. Eating disorders, pain management, premature ejaculation, autism spectrum disorders, cancer, hot flashes and premenstrual syndrome were identified as some of the off-label uses of escitalopram. For eating disorders; major depressive disorder, anxiety disorder, and obsessive compulsive disorder associated with abnormal eating patterns are all serious mental illnesses that often occur together, therefore escitalopram is used to alleviate the symptoms and conditions such as obesity resulting from this disorders. Escitalopram may alleviate pain through a number of different processes. Neuropathy pain can be alleviated by antidepressants because of their ability to block sodium channels. Patients with persistent erectile dysfunction (PE) whose condition is managed with daily escitalopram medication have reportedly seen changes in semen parameters. Some studies mentioned that escitalopram use gave relief from hot flashes and other menopausal symptoms within one week. Hepatocellular carcinoma (HCC) and autism were identified as other diseases managed with escitalopram. Lack of sufficient data to support use, and proliferated chances for adverse events were included as the drawbacks of off-label uses of escitalopram. However, certain factors such as fewer availability of approved treatments for the illness are considered in the off-label uses of escitalopram. Although escitalopram expands therapy possibilities for some individuals who had none before, it's crucial to remember that it does have some adverse effects that may lessen the quality of life for those who take it. Depression is a comorbidity for many of the off-label disorders. Therefore, in many circumstances, the antidepressant may just alleviate symptoms while more therapy is required to address the underlying cause of the depression. Evidence on off-label antidepressant usage must be generated and provided to clinicians in order to improve prescribing practices.