eng International Academy of Ecology and Environmental Sciences Ornamental and Medicinal Plants 2522-3682 2028-6-1 11 1-4 1 19 1 article WenJun Zhang 1 2 School of Life Sciences, Sun Yat-sen University, Guangzhou 510275, China; International Academy of Ecology and Environmental Sciences, Hong Kong Salvianolic acids, particularly salvianolic acid A (SAA) and salvianolic acid B (SAB), are the principal water-soluble polyphenolic constituents derived from the traditional Chinese medicinal herb Salvia miltiorrhiza Bunge (Danshen). With a history of over two millennia in treating cardiovascular disorders, these compounds have garnered substantial scientific interest due to their pleiotropic pharmacological activities. This comprehensive review synthesizes current knowledge regarding the discovery, physicochemical properties, extraction methodologies, pharmacokinetic profiles, and multifaceted therapeutic mechanisms of salvianolic acids. Preclinical evidence robustly demonstrates that salvianolic acids confer significant cardioprotective, neuroprotective, anti-inflammatory, antioxidant, anticancer, antiplatelet, hepatoprotective, and nephroprotective effects through the modulation of key signaling pathways, including NF-kB, Nrf2, MAPK, and NLRP3 inflammasome cascades. Clinical investigations, primarily utilizing injectable formulations, indicate favorable safety and tolerability in human subjects, with preliminary efficacy observed in mitigating major adverse cardiovascular events and angina as adjuvant therapy. However, the clinical translation of salvianolic acids is hindered by considerable challenges, most notably poor oral bioavailability attributable to low membrane permeability and extensive first-pass metabolism, as well as inherent chemical instability under physiological conditions. Ongoing research into advanced drug delivery systems, such as nanoparticle encapsulation and sustained-release formulations, presents promising avenues to overcome these pharmacokinetic limitations. While substantial progress has been made in elucidating the molecular pharmacology of salvianolic acids, further large-scale, multicenter clinical trials and in-depth mechanistic studies are imperative to fully establish their therapeutic utility and facilitate their integration into evidence-based global medical practice. http://www.iaees.org/publications/journals/omp/articles/2028-11(1-4)/salvianolic-acids.pdf salvianolic acid A salvianolic acid B Salvia miltiorrhiza cardiovascular protection anti-inflammatory pharmacokinetics bioavailability oxidative stress