Purpose of review Sarcopenia, the age-related loss of skeletal muscle mass and function, poses a major health challenge. While leucine's anabolic properties are well documented, its clinical efficacy as a standalone intervention remains limited. This review explores the potential of integrated strategies combining leucine with other nutrients, physical activity, and gut microbiota modulation to enhance sarcopenia prevention and treatment. Recent findings Recent studies confirm that leucine supplementation alone fails to significantly improve muscle mass or strength in older adults. However, its benefits emerge when combined with resistance training, or gut microbiota-targeted interventions. The gut-muscle axis has gained attention as a key modulator of muscle health. Additionally, leucine supports the resumption of physical activity in sarcopenic patients by mitigating exercise-induced muscle damage and inflammation. Summary These findings underscore the need for multimodal approaches, leucine, optimized nutrition, exercise, and microbiota modulation, to maximize therapeutic benefits. Future research should focus on defining optimal dosages, personalized protocols, and clinical feasibility. Such strategies could revolutionize sarcopenia management by integrating innovative, patient-centred care.