<p>Garlic (<i>Allium sativum</i> L.), belonging to the Alliaceae family, has been extensively utilized in culinary practices and traditional medicine since antiquity. Black garlic is produced by fermentation of fresh garlic under controlled temperature and humidity conditions. Significant differences exist between fresh and black garlic as a result of the fermentation process used in production, especially in terms of general and physicochemical composition, phenolic profile, antioxidant capacity, and other bioactive components. In addition, black garlic has numerous beneficial health effects, including antioxidant, anticancer, anti-inflammatory, antidiabetic, antiobesity, and cardiovascular protective effects. While the sharp and pungent odor of fresh garlic limits consumption, black garlic's sweet, roasted, and caramelized flavor profile is more preferred by consumers. This review provides a comparative analysis of the physicochemical, nutritional, and biological properties of fresh and black garlic. Specifically, the biochemical changes that occur during the fermentation process of black garlic are examined in terms of antioxidant capacity, phenolic compounds, organosulfur profile, and bioavailability. Furthermore, the advantages offered by black garlic over fresh garlic in terms of its aroma profile are evaluated.</p>