Anulom-vilom Pranayama/ alternate nostril breathing (ANB)/Nadi-suddhi pranayama is one of the common yogic breathing techniques and involves breathing through one nostril at a time while closing the other nostril manually. This study aimed to summarize effects of independent ANB on various physiological parameters, to evaluate safety issues in clinical populations and collect published primary scientific evidence on the benefits of ANB. PubMed/Medline, Cinahl, Web of Science and Google Scholar were searched using the following terms: Alternate nostril breathing, Anulom-vilom/ anuloma-viloma pranayama, Nadi-shodhan/Nadi-shodhana pranayama. Forty-four randomized controlled trials were included in this review paper. These studies evaluated the effects of alternate nostril breathing on parameters of the autonomic nervous system, cardiopulmonary system, cognitive functioning, problem solving and motor memory retention. Of the studies, ten showed a high level of bias; twenty-nine showed a low level of bias and five showed an unknown level of bias as per Cochrane systemic review guidelines. Most of the studies included healthy subjects and age range was eight to seventy years. Alternate nostril breathing has few variations and standardization of the technique is yet to be established. This technique provides high level evidence for positive outcomes for the autonomic nervous and cardiopulmonary systems. There is also high level of evidence regarding improvement in cognitive functioning with regular practice of alternate nostril breathing. More clinical trials are required to evaluate the effects of alternate nostril breathing in clinical populations and to synthesize effective frequency and duration parameters.