The integration of pharmacogenomics into traditional medicine presents a paradigm shift in healthcare, offering personalized treatment approaches while respecting cultural diversity and promoting social equity. This review synthesizes the current understanding of pharmacogenomics studies in traditional medicine, exploring the genetic basis of plant therapeutics and elucidating the ethical, legal, and social implications (ELSI) associated with this integration.Historically, traditional medicine has been deeply rooted in cultural diversity, encompassing diverse healing practices such as Ayurveda, Traditional Chinese Medicine (TCM), and Indigenous healing traditions. Pharmacogenomic studies have shed light on the genetic diversity of medicinal plants, revealing the intricate interplay between genetic variations and therapeutic efficacy. Case studies have demonstrated the influence of genetic variations on the production of bioactive compounds and the pharmacological activities of medicinal plants, highlighting the importance of genetic diversity in optimizing therapeutic outcomes.Methodologies employed in pharmacogenomic studies of traditional medicine include genomic sequencing, genome-wide association studies (GWAS), gene expression profiling, metabolomic analysis, and pharmacogenomic modeling. These methodologies enable researchers to unravel the genetic basis of drug response variability, identify predictive biomarkers, and optimize treatment strategies tailored to individual genetic profiles.However, the integration of pharmacogenomics into traditional medicine raises complex ELSI considerations that must be carefully addressed. Ethical considerations include informed consent, community engagement, benefit sharing, and cultural preservation. Legal frameworks governing the use of genetic information, intellectual property rights, and indigenous rights play a crucial role in shaping research conduct and ensuring equitable access to benefits. Social implications encompass cultural revitalization, health equity, interdisciplinary collaboration, and education and awareness efforts.To navigate these challenges, stakeholders must engage in transparent dialogue, foster partnerships with indigenous and local communities, and advocate for inclusive policies and practices. By embracing a holistic approach that values cultural sensitivity, ethical integrity, and social justice, we can harness the transformative potential of pharmacogenomics to advance personalized traditional medicine and improve health outcomes for all.