The article examines the therapeutic benefits and potential hepatotoxicity of Polygonum multiflorum (commonly known as He shou wu or Fo-ti), a traditional Chinese medicinal herb used for conditions such as liver injury, cancer, diabetes, alopecia, atherosclerosis, and neurodegenerative diseases. The review highlights various clinical studies, discussing the herb’s pharmacokinetics, pharmacodynamics, and therapeutic assessments, while also addressing concerns regarding its safety profile.