Advances and challenges in medicinal plant breeding

•Medicinal plants have significant economic and social benefits.•Global demand and consumption of medicinal plants has serious consequences for biodiversity and availability.•The complexity and particularity associated with medical plant breeding versus conventional crop breeding are highlighted.•This manuscript evaluates the current breeding methods, discusses their suitability under the current situation.•This manuscript considers the practical aspects of applying different techniques for breeding medicinal plants. Large-scale cultivation of medicinal plants is the most rapid and effective means of addressing the disparity between the supply and demand of medicinal plants. To achieve this scale of production, breeding studies are necessary for further development of medicinal plant cultivation. Although advances have been made in the breeding of some medicinal plants, a number of challenges remain, owing to the particularity and complexity in determining the breeding target. Additionally, there are limitations associated with research on traditional and modern breeding methods for medicinal plants. In this review, we summarize and analyze the selection strategies for breeding direction and breeding models, and emphasize the importance of breeding research in promoting the breeding of medicinal plants.