This review systematically and bibliometrically analyzes the green synthesis of Ag-ZnO nanocomposites using plant-based extracts, focusing on plant sources, mechanisms, medicinal applications, and toxicity. Results show that plant family influences nanoparticle size, with Lamiaceae yielding small sizes (5–45 nm) and Moringaceae producing moderate to large sizes (36–119 nm). Innovative plant sources like Curcuma longa and Azadirachta indica are explored. Ag-ZnO nanocomposites exhibit enhanced antibacterial, photocatalytic, and antioxidant activities, with mechanisms involving reactive oxygen species generation, metal ion release, and cell membrane interaction. The green synthesis approach offers advantages in sustainability, cost-effectiveness, biocompatibility, and simplicity. India, Iran, and Saudi Arabia lead research in this field, with Mashhad University of Medical Sciences being a prominent institution. Green synthesis, nanocomposites, and photocatalysis are key research trends. Future directions include improving degradation and recyclability, optimizing synthesis parameters, and expanding commercialization to fully realize the potential of Ag-ZnO nanocomposites in environmental and medical applications.
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