Polyamines such as putrescine, spermidine, and spermine are small, positively charged organic cations that interact with negatively charged molecules, notably nucleic acids. These molecules play a vital role in cell proliferation, differentiation, and growth. Their involvement in wound healing has attracted considerable research interest, as they are key regulators of keratinocyte and fibroblast proliferation—two cell types essential for re-epithelialization and tissue regeneration. Polyamines also influence gene expression and protein synthesis, facilitating the transition of cells from a quiescent to an active state during the healing process. Enzymes such as Adenosylmethionine Decarboxylase 1 (AMD1), which are involved in polyamine biosynthesis, are upregulated during wound healing and contribute to gene regulation at multiple levels. In parasitic protozoa—including Plasmodium falciparum (malaria), Trypanosoma spp. (sleeping sickness), and Leishmania spp. (leishmaniasis)—polyamines are crucial for DNA stabilization, protein synthesis, and cellular proliferation. These parasites depend on both endogenous polyamine synthesis and host-derived polyamines to sustain their metabolic functions. Notably, Plasmodium falciparum, the causative agent of malaria, possesses a bifunctional enzyme complex linking S-Adenosylmethionine decarboxylase (AdoMetDC) and ornithine decarboxylase (ODC), unlike the human form, where these enzymes are separate. This structural distinction makes the parasite’s AdoMetDC/ODC complex a promising target for drug development. In Mycobacterium tuberculosis (Mtb), polyamine metabolites have been shown to influence DNA methylation patterns, thereby affecting gene expression and bacterial adaptation. A 2025 study revealed that altered polyamine levels in the blood of patients with multidrug-resistant TB were associated with changes in Mtb DNA methylation, suggesting a potential role in resistance mechanisms. This chapter explores the multifaceted roles of polyamines in wound healing, parasitic infections, and tuberculosis-related bacteria. It also considers emerging technologies for wound treatment and highlights parasite-specific targets that may inform novel therapeutic strategies against TB.