Retinal neovascularization (RNV) diseases are one of the leading causes of visual impairment and blindness, including diabetic retinopathy, retinopathy of prematurity, retinal vein obstruction, and wet age-related macular degeneration. In recent years, fibroblast growth factor 21 (FGF21), a multifunctional metabolic regulator, has been found to exert a significant inhibitory effect on RNV. Therefore, this article systematically reviews the biological characteristics of FGF21, its molecular regulatory mechanisms in RNV diseases, and its potential therapeutic applications, aiming to provide a theoretical basis for developing novel FGF21-based treatment strategies for retinal diseases.

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