Black pepper (Piper nigrum L.) is widely regarded as the "king of spices" due to its enormous trading share in the world market. This worldwide trade is not only attributed to its pungency properties, but widely due to its great health benefits and richness in the bioactive components. From the ancient times to the modern science, the black pepper has evolved as a one of the important medicinal agents which is not only used in the kitchen for its nutritional and heath properties, but widely employed in the pharmaceutical sciences for its scientifically proven pharmacological actions and therapeutic role. These actions are mainly due to the presence of the alkaloids, flavonoids, steroids, phenols, amides, lignans, essential oil etc. Piperine, a piperidine alkaloid and its derivatives are widely employed as a bioavailability enhancer and produces synergistic effects with many other phytoconstituents or medicinal drugs and contribute to improve the bioactivity, dose reduction, and even lessen the side effects of many pharmaceutical drugs. Black pepper is widely employed to increase appetite, treats the hypertension, cough, sinusitis, vomiting, epilepsy, gastric problems, dyspnea, worm infections, and skin diseases. It also found to possess several important pharmacological properties such as antimicrobial, analgesic, anti-inflammatory, antioxidant, anticonvulsant, hypolipidemic, hypoglycemic, hepatoprotective, neuroprotective, and anticancer activities. Due to these wide applications, the trade of black pepper is increasing day-by-day all the world. The black pepper is mainly produced throughout the world especially in Vietnam, India, Indonesia, Brazil, Malaysia, China, and Sri Lanka. In India, Karnataka, and Kerala account for almost 55 % and 34 % of the total production respectively. The present review outlined the recent advancements in therapeutic potential of black pepper (Piper nigrum L.) along with its synergism and analysed the trade performance in terms of area, production, import and export of black pepper in the world focusing on India.