Rauvolfia consists of approximately one thousand species, evergreen trees and shrubs belonging to the family: Apocynaceae. ‘Reserpine’ is common phytochemical from Rauvolfia species which was broadly indicated as an antihypertensive drug. Rauvolfia tetraphylla L. a small tree shrub and a frequently available species of Rauvolfia which is prevalently used in Ayurvedic and unani system of medicines and also a part of folk remedies of most Asian countries. This review discusses pharmacognosy, phytochemistry, and pharmacological activities of R. tetraphylla. The leaf, stem and root of R. tetraphylla were pharmacognostically studied. Preliminary phytochemical study of different extracts revealed the presence of various phytoconstituents like reducing sugars, sugars, carbohydrates, alkaloids, amino acids, steroids, tannins, flavonoids, phenols, saponins, fixed oils, fats, gums, and mucilages. The stems and branches (air-dried) of R. tetraphylla provided a new labdane diterpene characterized as 3β-hydroxy-labda-8(17),13(14)-dien-12(15)-olide. Three antipsychotic indole alkaloids (IA) are namely, α-yohimbine, isoreserpiline, and 10-methoxy tetrahydroalstonine in R. tetraphylla leaf. Five new indole alkaloids rauvotetraphylline, together with eight known analogues, were isolated from the aerial parts of R. tetraphylla. Different activities including antibacterial, antifungal, anti-inflammatory, antioxidant, cytotoxic, cardio tonic and cardio protective was found from pharmacological view. In conclusion, from view point of pharmacognosy, phytochemistry and pharmacology R. tetraphylla is important medicinal herb.