Mahuang (Ephedra sinica) has been used widely to treat respiratory disease in traditional medicine for over thousands years. Mahuang preparations contain approximately 0.75~1% ephedrine alkaloids. Recently in North America, the Eephedra alkaloids has aroused a controversy due to its adverse effects in those using whole extracts as dietary supplements for weight loss or athletic performance enhancement. Objective : To discuss the need for clinical practice guidelines on the use of Mahuang. Results and Conclusion : It is widely assumed that Mahuang is one of the useful medicines and is safe for human body. Most of scientific literatures support that the safety of Mahuang prescription in common dosage. However, it has been claimed that there were some warnings and apprehensions about the harmfulness of Mahuang as dietary supplements. This article does not negate the fact that it is necessary to pay more attention for use of Mahuang in clinical situations. We assert that the establishment of clinical practice guideline on the use of Mahuang, which is based on scientific materials and consensus, is required in traditional medicine.