<p>Indonesian spices have long played a pivotal role in the nation’s culinary heritage and traditional medicine, while increasingly recognized for their potential as functional foods. This review highlights the dual significance of local spices, not only as cultural markers but also as sources of bioactive compounds with scientifically supported health benefits. By systematically examining ethnogastronomic practices and contemporary research, the paper bridges traditional uses with modern scientific validation. Representative bioactive compounds such as curcumin, gingerol, eugenol, cinnamaldehyde, and myristicin are discussed in relation to their anti-inflammatory, antioxidant, antimicrobial, antidiabetic, and cardioprotective activities. Examples of Indonesian dishes incorporating these spices demonstrate how culinary traditions enhance both sensory qualities and potential health effects. Furthermore, nutritional contributions of these spices, including micronutrients and fiber, are summarized to strengthen the functional perspective. The discussion extends to challenges such as standardization of doses, preservation of traditional knowledge, and integration of ethnogastronomy with scientific research. Opportunities for further study include clinical validation, improved processing methods, and potential applications in global food and health industries. This review integrates ethnogastronomy, nutrition, and bioactive science to underscore the role of Indonesian spices in promoting health while preserving cultural identity. This review is novel in systematically integrating ethnogastronomic context, nutrient composition, and mechanistic biomedical evidence to propose a pragmatic research and policy framework that facilitates translation of traditional spice use into validated functional-food applications.</p>