Cassia Semen is the mature seed of the leguminous plant Cassia obtusifolia L. or Cassia tora L. They are known for clearing heat, improving vision, and promoting bowel movements. Modern chemical research has shown that Cassia Semen is rich in anthraquinones, naphthopyranones, and fatty acids, among other chemical components. Pharmacological studies have demonstrated various effects of Cassia Semen, including lowering blood lipid levels, reducing blood pressure, regulating blood glucose, promoting bowel movements, protecting the liver, improving vision, exhibiting antioxidant and anti-aging properties, inhibiting bacteria, and exerting anti-cancer effects. By reviewing recent domestic and international modern research on Cassia Semen, this article provides a literature review on its chemical constituents, pharmacological effects, and recent progress in clinical studies. The aim is to offer references for the rational clinical application of Cassia Semen, the mechanisms of its pharmacological and toxicological effects, as well as the modern development of traditional Chinese medicine.