Kochiae Fructus (KF) is the fruit of an annual potherb Kochia scoparia (Linn.) Schrad and has been traditionally used for the treatment of diseases in the skin, eyes, and urinary tract for thousands of years in China. Recent studies have showed its anti-inflammatory, antifungal, antiallergic, and antipruritogenic effects to clarify the mechanisms of these actions. Meanwhile, its other effects, such as anticancer, hypoglycemic, and hepatoprotective effects, also have been reported. The achievement of these therapeutic effects is contributed by its chemical constituents. A total of 153 compounds have been identified in KF, mainly including triterpenoids, flavonoids, carbohydrates, amino acids, organic acids, and essential oils. Momordin Ic is the representative triterpene glycoside compound, which is used as a phytochemical marker for the quality control of Kochiae Fructus. The research on toxicity is insufficient, and only one article reported that the LD50 was 7.15 ± 0.03 g/kg for water extract of KF after oral administration in KM mice. In addition, the pharmacokinetic study was carried out on momordin Ic with linear pharmacokinetic characteristics. Above all, this review provides comprehensive information about Kochiae Fructus and may provide the theoretic foundation of its clinical application and further development.