The leaves and green fruit are cooked and eaten as spinach, sometimes with groundnuts, or simply mixed with porridge. The young leaves contain vitamin C. The raw ripe fruits are also eaten.

According to Watt and Breyer-Brandwijk (1962), the plant contains a bitter principle momordicin. They report that 'overseas a liniment, made by infusing the fruit (minus the seed) in olive or almond oil, is used as an application to chapped hands, burns and haemorrhoids and the mashed fruit is used as a poultice'. This practice probably explains the species name balsamina. Watt and Breyer-Brandwijk also list many medicinal and other uses of M. balsamina in tropical Africa and elsewhere.

Hutchings et al. (1996) report that the Zulu use infusions of this plant for stomach and intestinal complaints. It is also used in a poultice for burns and is reputed to be used to treat diabetes. The Vhavenda take leaf infusions as anti-emetics. There are conflicting reports on the toxicity of the fruit, both green and ripe. The green fruit contains a resin, toxic alkaloids and a saponic glycoside that cause vomiting and diarrhoea; these substances are denatured in the cooking process. The fruit is suspected of poisoning dogs and pigs.

Roodt (1998) states that the medicinal action of the fruit results from the saponic glycosides present. She reports uses in the Okavango delta and elsewhere for abortion, boils, burns, chapped hands and feet, external sores, frostbite, haemorrhoids, headache, and as a purgative.

The leaf sap is said to be an effective metal cleaner. In the past, the green fruit had been used as an ingredient of arrow poison. In the Okavango delta, the fruit can be used in cursing one's enemy; his/her stomach will burst in the same way that the ripe fruit bursts open spontaneously!