Pirfenidone has evinced noteworthy anti-inflammatory and antifibrotic efficacy in both animal models and in some clinical trials. Its pronounced potential for antifibrotic activity makes pirfenidone a compelling prospect for the treatment of various fibrotic diseases. Pirfenidone has several pleiotropic and anti-inflammatory mechanism of action through different molecular pathways. Consequently, it attenuates multiple inflammatory processes, including the secretion of pro-inflammatory cytokines, apoptosis, and fibroblast activation. Extensively studied for idiopathic pulmonary fibrosis, pirfenidone has exhibited a favorable impact, and represents part of the current treatment for this disease. In similar fibrotic diseases such as interstitial lung disease, myocardial fibrosis, glomerulopathies, aberrant skin scarring, chronic liver disease, and other fibrotic disorders, pirfenidone seems to exert a beneficial effect. Given the growing incidence of chronic fibrotic conditions, pirfenidone emerges as a potential therapeutic option for the management of these patients. Nonetheless, more clinical trials are needed to confirm its therapeutic effect. In this review, we aim to expose the current evidence of pirfenidone's effect in several fibrotic diseases.