Berberine (BBR), a naturally occurring compound with diverse medicinal properties, is emerging as a compelling candidate for managing age-related central nervous system conditions. Preclinical studies have extensively explored its impact on neurodegenerative diseases such as Parkinson's disease, Alzheimer's disease, and Huntington's disease, revealing its capacity to modulate key pathological processes. Mechanistically, BBR is shown to mitigate neuroinflammation, oxidative stress, and endoplasmic reticulum stress, thereby reducing neuronal damage and apoptosis. While these mechanistic insights and preclinical data are robust, clinical evidence remains nascent, necessitating further rigorous investigation to fully understand BBR's therapeutic efficacy and translate its promise into clinical practice. This narrative review provides a comprehensive examination of BBR's application in treating neurological conditions, emphasizing its molecular signaling pathways and critically evaluating the current translational landscape. It also identifies promising directions for future research into BBR's neuroprotective roles.