To provide a reference for rational clinical medication and review the irrational use and factors relating the adverse events of Polygonum multiflorum. The literatures on P. multiflorum published between 1978 and 2008 were reviewed and the reports on clinical use were analyzed. A total of 26 literatures were retrieved. 38 cases of adverse drug event were reported, 10 cases of allergy, 24 cases of liver damage, and 4 cases presented with other adverse events. Irrational use is common in both self-medication and doctor prescription. It is one of the main factors of adverse events. Improving clinical rational use is the most important way to control its risk.