Ischemia reperfusion (IR) injury, a common pathological process in clinical practice, is an important cause of tissue and organ damage in various critical conditions and perioperative periods. Astaxanthin (AST) is a natural active substance, with significant anti‑inflammatory, antioxidant, antiproliferative, and anti‑apoptotic properties. It can effectively bind to multiple molecular targets and is a potential therapeutic agent for various clinical diseases. This article focuses on the protective effect of AST on IR injuries in the heart, brain, liver, kidneys, intestines, limbs, and gonads. It summarizes and reviews the protective mechanisms involved in recent studies, promotes the understanding concerning the pharmacological activity of AST, and explores its therapeutic potential in tissue and organ IR injuries. These findings will contribute to the exploration of new strategies for the prevention and treatment of clinical IR injuries.