Burn wound management involves complex phases, with wound closure crucial for reducing mortality risk and achieving functional recovery. Though effective, traditional methods like skin grafting face limitations in extensive burns. Nile tilapia skin (NTS) has emerged as a promising alternative due to its high collagen content, biocompatibility, and moisture retention properties. A scoping review was conducted using EMBASE, Medline, and Cochrane Library databases. Inclusion criteria targeted studies using NTS in burn wound management across human and animal models. Outcomes analyzed included healing time, protein or gene expression changes, and cell proliferation. Articles were systematically screened and narratively synthesized. Of the 1035 articles retrieved, 13 met the inclusion criteria. Small-scale studies demonstrated that NTS accelerates wound healing, enhances re-epithelialization, and reduces pain compared to conventional treatments. Clinical trials highlighted faster recovery, decreased analgesic use, and fewer dressing changes in NTS-treated burns. However, these trials have marked limitations due to small study sample sizes, variability in application methods, and limited long-term outcome data. Mechanistically, NTS promotes cell migration, modulates inflammatory responses, and enhances angiogenesis. Its biocompatibility and antimicrobial properties further support its use. NTS represents a cost-effective, accessible alternative for burn wound management. However, standardizing protocols and conducting larger trials are essential for broader adoption. Addressing current treatment gaps can improve outcomes, particularly in low-resource environments. Further research is needed to standardize its use and optimize its therapeutic impact.