<p><i>Codonopsis</i> species, known for their therapeutic and nutritional properties, have become the center of attention because of their potential use as a source of drugs and their economic significance. However, threats, such as overharvesting, habitant degradation, and low natural propagation rates, are some of the causes of their unsustainability. <i>In vitro</i> propagation methods are excellent options for the mass multiplication, conservation, and genetic improvement of these important plant species, as well as for the biosynthesis of useful secondary metabolites. This review contains a brief account of the current tissue culture methods practiced on <i>Codonopsis</i> species, like organogenesis, somatic embryogenesis, protoplast cultures, artificial polyploidy induction, and adventitious root cultures. Estimating the importance of several regeneration efficiency factors, including additives, type of explant, media composition, concentration and combination of plant growth regulators, and carbon sources is the essence of this paper. In addition, the use of biotechnological tools in terms of synthetic seed production and genetic transformation in the improvement of propagation and secondary metabolite production are thoroughly discussed. Problems in plant micropropagation methods, like microbial contamination, browning, tissue necrosis, excess water in the tissues, and genetic instability, are deliberated on as an element of the process of culture protocol optimization. The review ends by underlining the promising outlooks that are all centered on the development of regenerated plants with a better magnitude of reproducibility, operability, and field performance of tissue culture-derived plants, ultimately supporting both commercial cultivation and long-term conservation. In this review, the potential is highly suggested of integrating <i>in vitro</i> technologies for the development of feasible and ecofriendly production and conservation strategies for <i>Codonopsis</i> germplasm.</p>