Boswellia, particularly Boswellia serrata, is a resin extract traditionally used in Ayurvedic medicine for its anti-inflammatory properties. In recent years, scientific interest has grown regarding its potential to modulate fibrosis, which is the pathological formation of excess fibrous connective tissue in organs such as the liver, lungs, kidneys, and heart. Laboratory and animal studies have provided some evidence that Boswellia extracts and their active constituents (notably boswellic acids) may inhibit key pathways involved in fibrogenesis, such as the TGF-β1/Smad and NF-κB signaling pathways. For example, preclinical studies have shown that boswellic acids can reduce markers of fibrosis in animal models of liver and pulmonary fibrosis by decreasing inflammation, inhibiting fibroblast proliferation, and downregulating profibrotic cytokines. However, direct clinical evidence in humans is very limited; there are few, if any, high-quality randomized controlled trials evaluating Boswellia for established fibrotic diseases. Most human data relate to its anti-inflammatory effects in conditions like osteoarthritis or inflammatory bowel disease, not fibrosis specifically. Thus, while the mechanistic and animal data are promising and provide a scientific rationale, clinical validation for its use in fibrosis is currently lacking, justifying a modest evidence rating.