Strychons nuxvomica is widely used by clinic and individual owing to its officinal value. Since toxic dose and therapeutic dose are very close, the poisoning cases are reported frequently. In this review, based on the recent available papers published in the PubMed and CNKI about Strychons nuxvomica, a traditional Chinese herbal medicine, we present the major current approaches in the field of composition, toxicology, pharmacokinetics, decreasing toxicity and increasing efficacy, in order to guide the use of S. nuxvomica in the clinic.