The plants of genus Zanthoxylum are effectually utilized in conventional and present-day medicine system to fight many diseases and disorders like pain, seizures, inflammation, cancer, liver and heart malady. Many of its plants-trees and shrubs, are citrus in nature, with curative antimicrobial, antihelminthic, antipyretic, and antiviral activities. More than 100 of its plant species have been identified and recorded for their potential as an herb in modern pharmacopeia. The species of this genus also have potent ethno-pharmacological significance. Many medicinal secondary metabolites like terpenoids, flavonoids, and alkaloids have also been profiled in many Zanthoxylum species. Additionally, fruit of many of the species is also significantly utilized as a major spice under the name "Sichuan pepper" in many countries like China and India. Thus, this unique blend of herb and spice characteristic of the genus needs a detailed description. This chapter highlights the major significant discoveries in the recent decade in this genus, which can add a step in the way of development of herbal medicines. Documentation of such medicinal plants may aid in derivation of plant-based medicines, which is the demand of the hour.