Rhodiola rosea, also called golden root, Arctic root, and rose root, grows in arctic and mountain regions throughout Europe, Asia, and America. Its use was first recorded by the Greek physician Dioscorides in 77 ce in De Materia Medica. It has been used for centuries as a traditional medicine in Russia, Scandinavia, and other countries for the treatment of fatigue, depression, anemia, impotence, GI ailments, infections, and nervous system disorders, and to promote physical endurance, longevity, and work productivity. Rhodiola appeared in the scientific literature of Sweden, Norway, France, Germany, the Soviet Union, and Iceland as early as 1725. Because most of the identified literature on this herb is from foreign language sources, I have relied largely upon secondary sources for this review. Rhodiola rosea has been an accepted medicine in Russia since 1969 for the treatment of fatigue, somatic and infectious illness, psychiatric and neurologic conditions, and as a psychostimulant to increase memory, attention span, and productivity in healthy individuals. It is also officially registered in Sweden and Denmark and is widely used in Scandinavia as a general tonic and to increase mental work ability under stress. Rhodiola is classified as an adaptogen. It contains a range of antioxidant compounds, and its adaptogenic activities are attributed to its unique phenylpropanoids rosavin, rosarin, and rosidirin, and to phenylethanol derivatives p-tyrosyl and salidroside (also called rhodioloside), as well as to flavonoids, triterpenes, monoterpenes, and phenolic acids. Rosavins are the accepted marker compounds for water and alcohol extracts. Research both from animal models and human clinical trials indicates a number of favorable effects associated with its use, including CNS stimulation, pronounced antistress effects, enhanced physical work and exercise performance, increased muscle strength, reduction in mental fatigue, and prevention of high altitude sickness. Cardioprotective and anticancer effects also have been attributed to its intake. Although research on Rhodiola has been extensive, it has also been described as “fragmentary,” with methods, statistics, and controls poorly defined. Further, not all studies have yielded positive outcomes for efficacy, although this may be related to product, dose, and duration of administration. Rhodiola rosea extract exhibited an anti-inflammatory effect and protected muscle tissue during exercise. Studies have demonstrated its ability to induce a general sense of well-being and reduce situational anxiety. It has demonstrated improvement in depressive syndromes, mental and physical fatigues secondary to medical conditions, sexual dysfunction, thyroid hypofunction (without causing hyperthyroidism), thymus gland functioning, adrenal functioning, and menopause-related conditions. Its mechanism of action is partly attributed to the herb’s ability to influence levels of monoamines, including serotonin, dopa-mine, and norepinephrine in the cerebral cortex, brainstem, and hypothalamus through inhibition of degradation enzymes and facilitation of neurotransmitter support in the brain. It also appears to prevent catechol-amine release and camp elevation in the myocardium, to prevent depletion of adrenal catecholamines by acute stress, and to induce opioid peptide biosynthesis and activation of central and peripheral opioid receptors. Enhanced antitumor and antimetastatic activity has been demonstrated when Rhodiola rosea extract is combined with cyclophosphamide (an antitumor agent).