When handling large file uploads in Node.js, loading an entire file into memory can quickly exceed the server’s memory limits, especially for files in the gigabyte range. A more efficient approach is to process file uploads in chunks using streams. Node.js's `stream` module allows you to read data incrementally without holding the entire file in memory, which makes it ideal for large uploads. Libraries like `multer` or `busboy` are commonly used for handling file uploads and can be configured to use streams for more memory-efficient processing. Additionally, streaming the data directly to a storage service like AWS S3 or Google Cloud Storage, rather than storing it on the server, reduces the server's memory usage further. You can also apply techniques like rate-limiting or chunking the upload to improve performance and prevent memory overload. By using streaming, you can safely handle large file uploads without risking memory exhaustion, making it a crucial technique for scalable Node.js applications.