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Neglected tropical diseases (NTDs) are a significant global health issue, affecting millions in low-income areas. Traditional treatments are often ineffective, causing side effects. Prodrug strategies could improve the pharmacological profiles of NTD drugs, addressing issues like efficacy, toxicity, and pharmacokinetics. Prodrug strategies offer a promising approach to enhancing the efficacy of NTD drugs by optimizing their delivery, activation, and pharmacological activity. This review provides a comprehensive overview of prodrug design, development, and optimization for NTD drugs, highlighting chemical and pharmacological aspects. This review discusses prodrug strategies for antiparasitic, anti-inflammatory, and immunomodulatory agents, focusing on activation mechanisms, pharmacokinetic and pharmacodynamic studies, and structure-activity relationships. It also addresses challenges in prodrug development, stability, formulation, and regulatory considerations. The review aims to inspire innovative solutions for improving NTD drug efficacy and patient outcomes.