Background: Body Protection Compound 157 (BPC-157) is a synthetic 15-amino-acid peptide derived from a gastric protein that has gained attention for its potential to enhance tissue repair. In recent years, a growing body of preclinical literature has reported beneficial effects of BPC-157 on muscle and other tissue healing. This narrative review summarizes and evaluates scientific evidence from 2019 to 2024 regarding BPC-157’s influence on muscle regeneration, tissue repair, and recovery, focusing on mechanistic insights and safety. Methods: Relevant peer-reviewed studies and high-quality preprints from 2019–2024 were identified through searches of PubMed and Scopus using terms related to BPC-157 and healing (e.g., BPC-157, pentadecapeptide, muscle injury, wound repair). Inclusion was limited to publications examining BPC-157’s effects on muscle or connective tissue healing. Articles on athletic performance enhancement were excluded. Both animal and human data were reviewed. Results: Recent animal studies demonstrate that BPC-157 markedly improves healing in models of muscle trauma. In rodent models of severed muscle-tendon injury, BPC-157 treatment restored structural integrity and function, whereas untreated injuries resulted in chronic deficits. Oral or parenteral BPC-157 accelerated muscle regeneration, including reattachment of avulsed muscle to bone with organized tissue architecture and regained biomechanical strength. Mechanistically, BPC-157 promotes angiogenesis and fibroblast activity: it stimulates endothelial nitric oxide synthase (eNOS) and angiogenic pathways leading to increased blood vessel formation and blood flow in injured tissues, and upregulates growth hormone receptors in fibroblasts, enhancing cell proliferation and collagen production. BPC-157 also exhibits anti-inflammatory and antioxidative effects, as evidenced by reduced inflammatory cell infiltration and normalized oxidative stress markers in healing muscle lesions. Human data remain limited; one small retrospective study reported significant pain relief and functional improvement in patients with knee injuries after intra-articular BPC-157, but controlled trials are lacking. Conclusions: Emerging evidence over the past five years reinforces BPC-157’s potent pro-healing effects in muscle and connective tissue injuries, largely in animal models. Its mechanisms of action likely involve angiogenesis (via eNOS/NO signaling), enhanced fibroblast-mediated repair (possibly through growth hormone receptor pathways), and modulation of inflammation. Available safety data indicate a favorable profile in animals and no reported adverse effects in early human use, though long-term safety in humans is not yet established. Given the promising preclinical results, BPC-157 warrants further investigation in clinical trials focused on muscle and tissue healing. Caution is advised in human use until robust clinical data are available.
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