Alzheimer’s disease (AD) represents the most common cause of dementia worldwide, accounting for approximately 60–70% of all dementia cases. It is characterized clinically by progressive memory loss, cognitive impairment, behavioral changes, and functional decline, ultimately leading to complete dependency and mortality. Pathologically, AD is marked by extracellular deposition of amyloid-β (Aβ) plaques, intracellular neurofibrillary tangles composed of hyperphosphorylated tau protein, synaptic degeneration, oxidative damage, and chronic neuroinflammation.

Despite decades of research, the therapeutic landscape of Alzheimer’s disease remains limited. Currently approved pharmacological agents—primarily acetylcholinesterase inhibitors and NMDA receptor antagonists—offer only transient symptomatic relief without halting disease progression. Moreover, emerging disease-modifying therapies targeting amyloid pathology have demonstrated inconsistent clinical benefits and raised concerns regarding safety, cost, and accessibility.

Against this backdrop, plant-based medicines have attracted renewed scientific attention. Traditional medical systems such as Ayurveda, Traditional Chinese Medicine, and ethnomedicine have long utilized medicinal plants for cognitive enhancement and neuroprotection. Modern pharmacological research increasingly supports the relevance of these botanical interventions, identifying bioactive phytochemicals capable of modulating multiple pathological pathways implicated in Alzheimer’s disease.

This review aims to provide a comprehensive and critical evaluation of plant medicines in the treatment of Alzheimer’s disease. By integrating ethnopharmacological knowledge with contemporary neuroscience and pharmacology, the paper examines the mechanistic rationale, experimental evidence, clinical relevance, and future prospects of neurophytotherapy in Alzheimer’s disease.