Lactotransferrin (LTF) is an iron-binding glycoprotein with multifaceted roles in immune defense and ferroptosis regulation. As a transcription factor, LTF exhibits antiproliferative properties and induces cell cycle arrest 1, binding to DeltaLf response elements in promoters of genes including SKP1, BAX, and SELENOH 2. Primarily, LTF functions as an antimicrobial agent with broad-spectrum antibacterial, antiviral, and antifungal activity 3, exerting these effects by sequestering iron essential for microbial growth 4. LTF also serves immunoprotective roles in human milk 5. Critically, LTF regulates ferroptosis—iron-dependent lipid peroxidation—through iron chelation and reduction of the labile iron pool 6. In hepatocellular carcinoma, the METTL16-SENP3-LTF axis confers ferroptosis resistance and promotes tumor progression 6. Conversely, in intracerebral hemorrhage, reduced LTF exacerbates neuronal ferroptosis in hyperglycemic mice; recombinant LTF treatment protects neurons and improves outcomes 7. In prostate cancer, the LTFe-LTF axis promotes ferroptosis and exhibits tumor-suppressive activity, disrupted by androgen receptor signaling 8. LTF emerges as a potential biomarker for nonspecific orbital inflammation 4, with diagnostic and prognostic significance across multiple disease contexts.