Summary: Meloxicam belongs to the group of nonsteroidal anti-inflammatory drugs (NSAIDs) that preferentially and more potently inhibit COX-2 than COX-1. In in vitro experimental studies, meloxicam inhibited COX-2 approximately 10 times more potently than COX-1; similarly, in human whole-blood assays, an approximately 11-fold preference of meloxicam for COX-2 was observed. The primary anti-inflammatory and analgesic mechanism of meloxicam, similar to other NSAIDs, is the reduction of prostanoid synthesis through competitive and reversible inhibition of arachidonic acid binding to the active site within cyclooxygenases. To date, two cyclooxygenase isoforms have been identified in humans – COX-1 and COX-2 – whose significance and expression depend on the tissue, phase of inflammation, and clinical conditions; therefore, the analgesic effect cannot be unequivocally attributed to COX-1 inhibition, nor can the anti-inflammatory effect be attributed exclusively to COX-2 inhibition. In meloxicam therapy, it is crucial to monitor the patient for treatment efficacy and safety, ensure the patient adheres to dosing recommendations and does not exceed maximum drug doses taking into account the ceiling effect for analgesia but not for adverse effects and determine the optimal duration of therapy based on the pain syndrome. This article presents the advantages and disadvantages of using meloxicam compared to other nonsteroidal anti-inflammatory drugs.