Irisin is a kind of cytokines mainly released by skeletal muscles, which is widely distributed in organisms. Studies have confirmed that irisin can regulate glucose and lipid homeostasis and have the therapeutic potential for the treatment of metabolic disorders like obesity and type 2 diabetes. The latest researches show that irisin has the properties of anti‑inflammation, anti‑apoptosis, and anti‑oxidation, which are related to the initiation, progression, and prognosis of numerous diseases like myocardial infarction, atherosclerosis, kidney diseases, liver diseases, and lung injury, suggesting that irisin can protect organ function through different mechanisms. In this paper we review multiple molecular pathways targeted by irisin therapy under various pathological conditions, which provides a new idea for clinical prevention and treatment of organ function injury.