C-X-C motif chemokine ligand 12 (CXCL12), often referred to as stromal cell-derived factor 1 (SDF-1), is a crucial factor for musculoskeletal biology. SDF-1 is a powerful chemokine that has been shown to have a significant impact on a variety of physiological functions, including tissue repair, homeostasis maintenance, and embryonic development. SDF-1 plays a dominant role in bone and cartilage metabolism. It directs mesenchymal stem cell migration, controls osteogenesis and chondrogenesis, promotes angiogenesis, and modifies the inflammatory environment. SDF-1 also acts as an inflammatory chemokine during joint inflammation, recruiting inflammatory mediators to act and cause bone and cartilage degradation, thus causing osteoarthritis. Age-related bone loss and osteoporosis is exacerbated by SDF-1, which is elevated in the peripheral circulation due to a phenomenon known as "senescence associated secretory phenotype" of SDF-1. SDF-1 is also implicated in cancer metastasis causing the spread of secondary malignancies. Thus, the aim of this review is to explore the complex methods by which SDF-1 affects the fine equilibrium of bone and cartilage metabolism, providing insight into its importance in both healthy and diseased conditions.