The medicinal use of mushrooms, so-called higher fungi, has a very long tradition in the Asian countries, whereas their use in the Western hemisphere has been slightly increasing only since the last decades. The paper gives an overview about the most important medicinal mushrooms and summarizes the actual knowledge about chemistry and pharmacology of Lentinula edo-des (Shiitake, Golden Oak Mushroom), Ganoderma lucidum (Reishi, Ling Zhi), Agaricus brasiliensis (Royal sun agaricus), Grifola frondosa (Maitake, Hen-of-the-Woods) and Hericium erinaceus (Yamabushitake, Lion's Man, Monkey's Head).