The medicinal activities of garlic organosulfur compounds identified include antitumor, antimicrobial, antifungal, antivirus, anti-atherosclerosis, blood lipids and sugar lowering, antithrombotic, anti-hypotension and immune modulation effects. These multi-targeted new agents may be especially promising since recently developed highly specific anti-cancer agents as well as other disease treatment drugs have failed to live up to the expectations. Despite more than one thousand articles have been published on garlic organosulfur compounds, the drug metabolism and pharmacokinetics of these compounds behind their health-promoting effects are still poorly understood. In this review, we will focus on metabolic pathways and pharmacokinetics of organosulfur compounds from garlic, which is intended to fill the void on the important aspect for further nutraceutical and pharmaceutical product development of this group of compounds. The effects of these organosulfur compounds on various cytochrome P450 enzymes as well as on P-glycoprotein (P-gp) and multidrug resistance proteins (Mrp1 and Mrp 2) will also be discussed.