The repository of molecules (secondary metabolites) in plants have been identified as an effective candidate to cure human diseases. This immense potential is continuously being utilized by exploiting natural plant resources. Such practices led to environmental imbalances and many natural sites were deserted. This chapter provides current perspectives on plant hairy root cultures as an important model for sustainable therapeutic secondary metabolite production. Here, the imperative interventions of biotechnology to enhance the accumulation of such molecules are discussed. Current research trends for metabolite enhancement through media optimization, elicitation, precursor feeding, metabolic engineering, and up scaling are taken into consideration.