Gastric ulcer is the most common disorder of the upper digestive tract. The prevalence of gastric ulcer is 2.4% in the Western population[1] and annual incidence rates range from 0.10% to 0.19%[2]. In certain regions of Mainland China, the prevalence of gastric ulcer is as high as 6.07% in the general population, and 22.5% of patients with gastrointestinal symptoms have gastric ulcer[3,4]. Higher incidence usually occurs in people who smoke, use nonsteroidal anti-inflammatory drugs (NSAIDs), or consume alcohol[5-8]. The recurrence rate is as high as 60%[9]. Gastric ulcer has a significant economic impact. Average annual medical costs are $23819 for gastric ulcer in the United States[10]. In South Korea, the annual medical costs for gastric ulcer range from $959.6 to $2553.10[11]. Although some studies have demonstrated that Helicobacter pylori (H. pylori) eradication therapy is cost-effective[12], a more systematic study indicated that there was no significant cost difference per subject between eradication therapy and placebo[13]. Although conventional regimens are effective, their side effects are often inevitable and limit clinical utility[14-16]. However, both clinical and experimental studies have demonstrated that herbal medicines exhibit therapeutic benefit for gastric ulcer with fewer side effects. Moreover, the cost of herbal medicine for gastric ulcer is only about one-sixth of that of Western medicine[17]. In this paper, the efficacy, safety and mechanisms of action of herbal medicines in treating gastric ulcer are reviewed.