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Alismatis Rhizoma is a traditional Chinese medicine (TCM) derived from the dried rhizomes of *Alisma orientale* (Sam.) Juzep. or *Alisma plantago-aquatica* Linn. It is widely utilized for its diuretic, lipid-lowering, and anti-inflammatory properties. The therapeutic efficacy of Alismatis Rhizoma is attributed to its diverse chemical constituents, primarily triterpenoids (such as alisol A, alisol B 23-acetate, and alisol C 23-acetate) and polysaccharides (arabinogalactans). Research indicates that these components exert protective effects against metabolic dysfunction-associated steatohepatitis (MASH), hyperlipidemia, and obesity by modulating targets such as SIRT1, pancreatic lipase, and bile acid-CoA: amino acid N-acyltransferase (BAAT). Additionally, Alismatis Rhizoma has shown potential in treating acute liver injury, diabetic nephropathy, and hypertension through multi-target regulatory paradigms involving the activation of JNK/p38 MAPK signaling and the modulation of gut microbiota.
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