Background: Annona muricata (soursop) is widely used in traditional medicine for conditions associated with infection, inflammation, fatigue, and anemia-like symptoms. Its potential relevance to hematopoiesis remains underexplored. Oxidative stress and chronic inflammation are recognized contributors to hematopoietic stem and progenitor cell dysfunction and disruption of bone marrow homeostasis. Objective: To critically synthesize ethnomedicinal knowledge, phytochemical findings, and experimental evidence concerning the potential indirect influence of A. muricata on hematopoietic regulation, and to identify priorities for translational research.Methods: A narrative literature review was conducted using PubMed, Scopus, Web of Science, Google Scholar, and African Journals Online (AJOL). The search covered January 2000 to June 2025 and combined terms relating to A. muricata, hematopoiesis, bone marrow, anemia, blood cells, immunomodulation, oxidative stress, and inflammation. Relevant peer-reviewed ethnomedicinal, in vitro, in vivo, and review literature was synthesized thematically; no meta-analysis was undertaken.Findings: The reviewed literature describes antioxidant, anti-inflammatory, and immunomodulatory activities of A. muricata constituents, including flavonoids, polyphenols, and acetogenins. These activities provide biological plausibility for indirect, marrow-supportive effects through modulation of oxidative stress, inflammatory signaling, and immune-related pathways. However, the evidence is heterogeneous and predominantly preclinical. Direct evaluation of hematopoietic stem and progenitor cell function, bone marrow-specific outcomes, and human hematological endpoints is limited. Preparation variability, uncertain dose–response relationships, and safety concerns—including potential acetogenin-associated neurotoxicity—further constrain interpretation.Conclusion: Current evidence does not establish A. muricata as a treatment for anemia or other hematological disorders, nor does it demonstrate direct erythropoietic activity. Its possible relevance is best viewed as a research hypothesis requiring standardized preparations, rigorous toxicological assessment, and studies incorporating validated hematological endpoints before clinical application can be considered.Keywords: Annona muricata; soursop; hematopoiesis; immunomodulation; oxidative stress; ethnomedicine; translational research