Although controversial, Creosote bush, Larrea tridentata (Sesse and Moc. ex DC) Coville, is used to treat a variety of illnesses including infertility, rheumatism, arthritis, diabetes, gallbladder and kidney stones, pain and inflammation. Recently, it has been used as a nutritional supplement. The primary product extracted from this common plant of the arid regions of northern Mexico and Southwestern United States is the potent antioxidant nordihydroguaiaretic acid (NDGA). It was widely used during the 1950s as a food preservative and to preserve naturals fibers. Later it was banned after reports of toxicity during the early 1960s. Renal and hepatotoxicity are also reported for chronic use of creosote bush and NDGA. This article reviews traditional and contemporary uses and pharmacology, including toxicology of this plant widely used in Mexican traditional medicine.