Rhamnus alaternus, is a wild-growing shrub, belonging to the Rhamnaceae family. Widely distributed in the Mediterranean basin, R. alaternus is used in the usual medicine in numerous countries, mostly Tunisia, Algeria, Morocco, Spain, France, Italy, and Croatia. A large number of disorders—including dermatological complications, diabetes, hepatitis, and goiter problems—can be treated by the various parts of R. alaternus (i.e., roots, bark, berries, and leaves). Several bioactive compounds were isolated from R. alaternus, including flavonoids, anthocyanins, and anthraquinones, and showed several effects such as antioxidant, antihyperlipidemic, antigenotoxic, antimutagenic, antimicrobial, and antiproliferative. This review summarizes the updated information concerning the botanical description, distribution, extraction processes applied on R. alaternus, and its ethnopharmacology, toxicity, phytochemistry, and pharmacological effects.