The increasing global demand for medicinal and aromatic plants (MAPs) has placed significant pressure on natural ecosystems due to extensive wild harvesting. Medicinal and Aromatic Agroforestry (MAAF) offers a sustainable alternative by integrating MAPs with tree-based systems to enhance productivity while conserving ecological integrity. This study reviews the ecological, biochemical, and socioeconomic benefits of MAAF, including improved soil health, biodiversity conservation, carbon sequestration, and microclimate regulation. Various agroforestry models such as Agri-silviculture, multi-strata systems, forest farming, and Silvo-pastoral practices are evaluated for their adaptability and economic potential. The influence of shade on secondary metabolite production, a key determinant of MAP quality, is also highlighted. Additionally, challenges such as allelopathy, resource competition, and inefficient value chains are discussed along with management and post-harvest strategies. The role of international regulatory frameworks in promoting sustainable trade is emphasized. Overall, MAAF emerges as a viable approach for sustainable land use, ensuring ecological restoration and improved rural livelihoods.