Salsalate is primarily used as a nonsteroidal anti-inflammatory drug (NSAID) for the management of mild to moderate pain, inflammation, and stiffness caused by conditions such as osteoarthritis and rheumatoid arthritis. It works by reducing the production of prostaglandins, which are chemicals in the body that cause pain and inflammation.

One of the key advantages of salsalate is its gastrointestinal tolerability. Because it is a prodrug that is converted to salicylic acid mainly in the intestines and liver, it tends to cause less direct irritation to the stomach lining compared to other salicylates like aspirin.

Salsalate has also been studied for its potential use in managing type 2 diabetes due to its ability to reduce insulin resistance and lower blood glucose levels through anti-inflammatory effects on metabolic pathways. However, this use remains off-label and is not widely adopted in clinical practice.

It is commonly prescribed for patients who require long-term pain relief and who may be at higher risk for gastrointestinal side effects with other NSAIDs.