Opuntia elatior Mill. (OE) (Family Cactaceae), commonly recognized as Red Prickly pear, is a plant of varied nutritional and medicinal benefits. The species has been scrutinized for the composition and wide array of pharmacological activities. This review is attempted with an aim to document the updated status of OE with respect to its phytochemistry and pharmacological actions. The data is collected from the extensive review of literatures from scientific articles, dissertations and books available on various web-based search engines such as Pub-med, Google-scholar and Science direct and few unpublished observations. The fruit is reported to be rich in carbohydrates, flavonoids, phenolics, betalains, vitamin C and minerals like calcium, magnesium, iron, zinc, copper, and potassium. Extract and the fruit as a whole are reported for anti-oxidant, hematinic, anti-leukemic, anti-diabetic, analgesic and anti-inflammatory, anti-fertility, broncho-dilatory, mast cell degranulation, radio-protective and anti-arthritic activities. It is reported to be safe for administration in a dose dependent manner. OE is a nutritionally and medicinally important drug with a wide range of traditional and pharmacological applications. There is a vast scope for research on the varied traditional claims of this drug. This review might help for the further research on the species.