Medicinal plants research in Asia continues to receive significant national and international attention, particularly concerning its multiple roles in poverty alleviation and health care support. However, scientific information on the institutional arrangements, the potentials of different medicinal plants production systems, and the utilization methods, remain highly fragmented. This incomprehensive information base shades the development of a comprehensive research agenda to improve the current body of knowledge, at least in the context of Asia. To address this impasse and propose future research perspectives, we systematically reviewed 247 journal articles, 15 institutional reports, and 28 book chapters. From the reviews, five key lessons are drawn: (i) Asian medicinal plant production systems demonstrate some dynamics, characterized by a gradual but continuous shift from wild gathering to cultivation, (ii) sub-regional variations exist with regards to the appreciation of medicinal plants potentials for traditional healing, modern healthcare, and livelihoods support, (iii) knowledge on the effect of multi-scale institutional arrangements (formal and informal) on medicinal plant management practices is fragmented, (iv) very few studies dwell on the challenges of medicinal plants commercialization, particularly with regards to the role of middlemen, boom-bust cycle, raw material readiness, and product quality, and (v) law enforcement, benefit and knowledge sharing, and research and development should be prioritized to serve the interest of medicinal plants production actors. To further extend the body of knowledge on medicinal plants in Asia, we advance the need for empirical investigations on the performance of medicinal plants production systems and their contribution to livelihoods in diverse institutional contexts.