Dendrobium nobile ( D. nobile), an orchid species deeply rooted in traditional medicine, has garnered considerable attention for its potential pharmacological and therapeutic properties. This critical review provides a comprehensive analysis of the bioactive compounds present in D. nobile and explores their diverse pharmacological effects. The phytochemistry of D. nobile has been discussed, highlighting its major constituents and bioactive compounds with specific properties. The pharmacological profile of D. nobile has been investigated in various domains. Notably, its strong antioxidant activity and ability to scavenge free radicals have been shown to support its immune-modulating, anti-inflammatory, and neuroprotective effects. Intriguingly, these orchids display promising anticancer, antidiabetic, cardiovascular, renoprotective, hepatoprotective, and wound-healing properties. The mechanisms underlying these effects were explored, including molecular pathways and signalling cascades. However, factors influencing its chemical composition, such as environmental conditions, cultivation techniques, and postharvest processing, must be considered for consistent therapeutic outcomes. The safety and toxicity profiles derived from acute and chronic toxicity studies were examined. In future studies, exploring the untapped therapeutic potential and elucidating the intricate mechanisms of action are promising. This review underscores the pharmacological richness of D. nobile, revealing its potential to contribute to modern medicine while emphasising the need for further investigation to harness its full therapeutic benefits.