This review examines the therapeutic potential of resveratrol (RES) in managing degenerative musculoskeletal diseases (DMDs), including osteoarthritis (OA), osteoporosis, and sarcopenia. With the rising incidence of these diseases in aging populations, effective interventions are increasingly urgent. RES, a polyphenolic compound found in foods such as grapes and peanuts, has shown promise due to its antioxidant and anti-inflammatory properties. Acting within the framework of medicine and food homology, RES holds dual roles as both a dietary supplement and therapeutic agent. RES exerts its effects by modulating various signaling pathways, which collectively reduce inflammation, oxidative stress, and cellular apoptosis, thereby slowing the progression of DMDs. Clinical trials suggest that RES improves bone mineral density, alleviates OA symptoms, and helps preserve muscle mass. However, challenges like limited bioavailability and targeted delivery remain. Future research should focus on optimizing RES’s bioavailability and exploring its synergistic effects with other natural compounds to enhance its therapeutic impact. Overall, RES exemplifies a holistic approach to DMDs management by integrating dietary and pharmacological benefits, offering a sustainable strategy for disease management and prevention.