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Notoginseng (commonly known as notoginseng or sanqi) is an herb primarily indicated for blood- and circulation-related conditions. In traditional Chinese medicine, notoginseng is often used together with other herbs to halt both internal and external bleeding, although the effects are mostly attributed to notoginseng itself. Experimental findings have provided support to other effects, such as anti-inflammatory, anti-fibrotic, immunostimulatory, neuroprotective, of notoginseng as well. The effect on bleeding is, however, more complicated. There is mounting evidence that notoginseng possesses both pro-haemostatic and anti-haemostatic properties. The apparently paradoxical effects may owe to factors including herbal preparation methods, experimental parameters and metabolic activity of the herb. This editorial highlights selected literature which may be of considerable value in future research concerning how notoginseng affects haemostasis.