Metabolic syndrome (MetS) is a prevalent, multifactorial and complex disease that is
associated with an increased risk of developing diabetes and other major cardiovascular complications.
The rise in the global prevalence of MetS has been attributed to genetic, epigenetic, and environmental
factors. The adoption of sedentary lifestyles that are characterized by low physical activity and the
consumption of high-energy diets contributes to MetS development. Current management criteria
for MetS risk factors involve changes in lifestyle and the use of pharmacological agents that target
specific biochemical pathways involved in the metabolism of nutrients. Pharmaceutical drugs are
usually expensive and are associated with several undesirable side e ects. Alternative management
strategies of MetS risk factors involve the use of medicinal plants that are considered to have multiple
therapeutic targets and are easily accessible. Medicinal plants contain several di erent biologically
active compounds that provide health benefits. The impact of phytochemicals present in local
medicinal plants on sustainable health and well-being of individuals has been studied for many years
and found to involve a plethora of complex biochemical, metabolic, and physiological mechanisms.
While some of these phytochemicals are the basis of mainstream prescribed drugs (e.g., metformin,
reserpine, quinine, and salicin), there is a need to identify more medicinal plants that can be used for
the management of components of MetS and to describe their possible mechanisms of action. In this
review, we assess the potential health benefits of South African ethnomedicinal plants in protecting
against the development of health outcomes associated with MetS. We aim to provide the state of the
current knowledge on the use of medicinal plants and their therapeutically important phytochemicals
by discussing the current trends, with critical examples from recent primary references of how
medicinal plants are being used in South African rural and urban communities.