<p>Zinc oxide nanoparticle (ZnO NP) applications in a range of domains, such as commercial products, science, technology, medicine, and farming, have expressed worries regarding their release into the atmosphere. This led to an increase in public anxiety over these particle’s environmental and toxicological impacts. The assessment of biomedical and agricultural applications focusing on genotoxicity and therapeutic potential. This review article scrutinizes the dual nature of ZnO NP, which demonstrates genotoxic consequences, basic practices, and approaches to decrease toxicity by making agricultural and therapeutic benefits. Studies assessing oxidative stress, DNA damage, chromosomal aberrations, and apoptosis in plant and animal cells were analyzed alongside reports demonstrating their antibacterial, anticancer, and plant growth-promoting properties. Approaches aimed at reducing toxicity, like green synthesis, surface modifications, and dose optimization, were also examined. ZnO NPs display antibacterial and anticancer activities and show potential in reducing antimicrobial resistance. They hold promise in cancer therapy and drug delivery. Nonetheless, cytotoxicity and genotoxic effects limit clinical translation. ZnO NPs improve crop yields, enhance plant growth, and provide pest resistance. However, they also interfere with soil microbiota and may integrate with plant genomes, raising biosafety concerns. These nanoparticles exhibit beneficial and toxic effects on plant and animal cells. They show promise in agriculture and medicine, offering solutions for crop protection, antimicrobial resistance, and cancer treatment. But their genotoxic and cytotoxic risks pose considerable challenges to safe applications. Future research should prioritize eco-friendly synthesis, precise dose optimization, and functional surface modifications to balance therapeutic and agricultural benefits while minimizing biosafety concerns.</p> Graphical abstract <p></p>