As a commonly used medicinal material, Areca catechu is widely used in prescriptions. It is native to Malaysia and is cultivated mainly in subtropical regions of China such as Hainan and Taiwan. The main chemical components of Areca catechu are alkaloids, phenols, amino acids, polysaccharides, minerals, crude fiber, grease and vitamins, etc. In the clinical practice, Areca catechu is not only used as insecticides, but also on various intestinal diseases, arthritis, glaucoma and other diseases. Areca catechu medications are mostly used for children and the elderly. The main pharmacological activity compound of areca catechu is arecoline, but it’s reported that arecoline can not only cause cancer, promote cancer, but also reduce the body"s immunity and increase the probability of carcinogenesis. However, in clinical practice, Areca catechu is used in combination preparations, and there are no reports of carcinogenic side effects of Areca catechu when it is used with other medicines at regular doses. This article reviews the chemical constituents, pharmacology and research progress in clinical application of Areca catechu, and provides reference for the scientific development and safe and rational use of Areca catechu.