<p><i>Gentiana straminea</i> Maxim. (GSM), a cornerstone medicinal plant in Tibetan ethnopharmacology, has been utilized for over two millennia. This species exhibits a wide distribution across China, predominantly in the northwest. Its roots and flowers characterized by bitter, pungent taste and neutral properties are used medicinally. Traditional applications include treating rheumatoid arthritis, icteric hepatitis, leprosy, and “toxic heat” syndromes. Recent research has identified critical bioactive constituents: secoiridoids (gentiopicroside, swertiamarin, sweroside), loganic acid, flavonoids (vitexin, isovitexin), volatile compounds, and saccharides. GSM demonstrates significant pharmacological activities, including anti-inflammatory, analgesic, antioxidant, hepatoprotective, cardioprotective, anti-hypoxic, anti-bacterial, and insecticidal effects. By systematically reviewing domestic and international literature from the past two decades, this study summarizes the morphological characteristics, resource distribution, breeding practices, cultivation methods, chemical composition, and pharmacological actions of GSM. The aim is to provide a scientific basis for its cultivation, identification, rational clinical application, and to promote its development and utilization.</p> Graphic Abstract <p></p> <p>Botany, pharmacological effects, and chemical composition of <i>Gentiana straminea</i> Maxim.</p>