Historically, iodine in its iodized stain form has been used for more than a century as an antiseptic. However, despite its effectiveness, its use has been largely compromised by its numerous side effects, such as burning, irritation and allergies. Guidelines on the use of povidone-iodine (PVI) in evidence-based ophthalmology place this solution at a concentration of 5-10% as the gold standard in the prophylaxis of endophthalmitis prior to cataract surgery and intravitreal injections. The purpose of this review is to present the current evidence on the use of PVI in ophthalmology, in addition to its indications not yet approved at concentrations below 5%.