Alisma orientale (Sam.) Juzep. is a traditional medicinal herb whose modern research has revealed remarkable biological and pharmacological breadth. Studies on its germplasm diversity, ecological adaptation, and quality formation indicate that genetic background and environmental factors jointly shape its medicinal value. Chemically, A. orientale is characterized by abundant protostane-type triterpenoids—particularly alisol derivatives—along with diverse sesquiterpenoids, phenolics, alkaloids, polysaccharides, and proteinaceous components. These constituents collectively contribute to wide-ranging bioactivities. Pharmacological investigations demonstrate multi-system actions including regulation of lipid and glucose metabolism, protection of hepatic and renal systems, suppression of inflammatory and oxidative stress pathways, modulation of cardiovascular and platelet functions, and benefits in ocular and neurological disorders. Mechanistic studies highlight the involvement of key metabolic, inflammatory, and stress-responsive signaling networks that underlie these effects. In addition, multi-herb formulas containing A. orientale show synergistic therapeutic potential in metabolic diseases, renal injury, cardiovascular dysfunction, and neuroinflammatory conditions. Overall, the expanding body of evidence depicts A. orientale as a chemically complex, multi-target botanical resource with significant relevance for modern prevention and treatment of metabolic and inflammation-related disorders. Further integration of biological, phytochemical, and pharmacological insights will support its continued modernization and standardized clinical application.
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