Polygala fallax Hemsl., a species belonging to the genus Polygala and the family Polygalaceae, is primarily distributed in southern China. Wild P. fallax Hemsl. (Polygalaceae) is currently endangered, but its utilization value has not yet been thoroughly investigated. The present review summarizes the morphological and structural characteristics, wild resource distribution, chemical constituents and pharmacological efficacy, artificial breeding and cultivation techniques, and utilization value of P. fallax Hemsl. (Polygalaceae) to facilitate future studies on the conservation and use of P. fallax Hemsl plants. We conclude that (i) P. fallax Hemsl. (Polygalaceae) is a medicinal and edible plant, and also has eco-economic and ornamental value; (ii) roots are the primary medicinal parts, which contain pharmacologically active compounds such as saponins, flavones, oligosaccharide polyesters, polysaccharides, sterols, organic acids, etc.; and (iii) P. fallax Hemsl. (Polygalaceae) shows various pharmacological efficacies including anti-inflammatory effects, antivirus effects, antioxidative effects, an immunity-boosting function, hepatic-protective effects, hypolipidemic effect, blood-activating, stasis-eliminating effects, and antitumor, etc. More research on the applications of P. fallax Hemsl. (Polygalaceae) are needed, especially efforts to identify its effective constituents, pharmacological efficacy, quality control, and clinical applications. The use of P. fallax Hemsl. (Polygalaceae) resources should be enhanced, especially the use of the aboveground parts, and the pharmacological efficacy of other chemical constituents, such as flavones and polysaccharides, should be further explored.