This review explores the interaction between BPC 157, a stable gastric pentadecapeptide, and the nitric oxide (NO) system. BPC 157 modulates NO pathways, counteracting both NO synthase inhibition (e.g., L-NAME-induced hypertension) and overactivation (e.g., L-arginine-induced hypotension). It promotes vascular integrity, reduces thrombosis and bleeding, and enhances healing across various tissues.