Introduction. Alcoholic fermented rice-based beverages (AFRBs) have been used since time immemorial for spiritual connection and cultural rituals in North-East India. AFRBs are also used traditionally in the healthcare system for remedy of tiredness, digestion problems, hypertension, and diabetes. Problems Statement. Limited scientific documents are available on AFRBs including starter cake preparation, production of the beverages, microbial intervention, nutritional aspects, and health benefits. Objectives. This review has been undertaken to find insight into ethnic preparation, microbial intervention, ethnobotany, and health benefits as well as nutritional aspects of popular AFRBs of North-East India. Major Findings. Studies reveal that AFRBs are enriched with medicinal benefits due to the presence of various microflora and medicinal plants. The presence of medicinal plants plays an important role underlying the health benefits of AFRBs. In addition, several functional microorganisms, such as strains of Lactobacillus and yeast, enhance the therapeutic potential of the AFRBs. Interestingly, strains of Pediococcus and Lactobacillus spp. improve bile and gastric juice tolerance, hyperlipidemia, diabetes, obesity, and amylolytic activities and regulate the expression of fatty acid biosynthetic genes. Moreover, strains of Saccharomyces decrease the secretion of proinflammatory cytokines and alter the respective mRNA expression. Furthermore, the consumption of AFRBs has no harmful effect among the communities on a regular basis in normal diet. Conclusion. A detailed scientific approach is required to maintain the desired product quality of AFRBs for the upliftment of the socioeconomic status of North-East India.