The production of Nile tilapia, Oreochromis niloticus, over the last few years has increased due to the adoption of intensive farming technologies. However, the continuous increase in O. niloticus production must be based on sustainable practices. Probiotic use in O. niloticus culture is considered a good alternative in improving growth, feed utilization, immune status, and survival against pathogens which are common problems currently faced in intensive culture systems. Nutrient utilization of fish is one of the criteria that determines the production, profitability, and productivity of the aquaculture industry. However, research on probiotics in aquaculture, especially in O. niloticus culture, is much geared towards immunity and disease resistance while areas of equal importance such as nutrient utilization which translates into good health and growth as well as hepatic indexes which detect tissue damage caused by toxicants are less explored. The present review elucidates the effects of probiotics on nutrient utilization (proteins, lipids, fatty acids, carbohydrates, vitamins, and minerals), growth, immune status, and disease resistance of tilapia. Furthermore, this review tries to point out gaps in existing literature that warrant further investigations and development