Background: The term "anabolic steroids" (also known as "anabolic-androgenic steroids" or "AAS") refers to a broad class of both artificial and naturally occurring androgens. In 1935, the endogenous androgen testosterone was isolated, described, and made available for external administration. Since then, extensive research and development have resulted in the production of a large number of testosterone derivatives, each of which has a different structural makeup and distinct features. There is a dearth of reviews that explore the causes, effectiveness, and patterns of AAS usage, despite the fact that there is a wealth of literature on the negative effects of AAS use. The objective of this review is to close this gap while also educating and updating the clinician on the underlying basic science of AAS and the prognostic implications of AAS use. Conclusion: The negative effect profile of AAS use has long been a point of debate, with opinions on how serious the problem is varied. Our study demonstrates that the negative effects of AAS are actually distributed throughout several organ systems, although further, ideally prospective-designed trials are still needed to determine their full extent. The clinician may utilize the increased risk of early death, the emergence and potential hemorrhagic rupture of hepatic adenomas, and the potential for continuing infertility for up to two years after AAS discontinuation as arguments to discourage users from abusing AAS.