As a traditional Chinese herbal formula, Xiasangju (XSJ) is widely used in China for antipyresis and influenza treatment. However, XSJ still fails to have a comprehensive summary of the research progress in the last decade. This review summarizes the advanced research on the extraction process, phytochemistry, pharmacological activity, and quality control of XSJ. Current research mainly focuses on quality control and the pharmacological effects of single herbs and active ingredients, but many pharmacological mechanisms of the formula are unclear. The development of active ingredients reflects the active characteristics of triterpenes, phenolic acids and flavonoids, but the hepatotoxicity of Prunella vulgaris L. has not been taken into account. XSJ has extensive historical practical experiences, while systematic clinical trials remain lacking. Therefore, it is necessary to study the active ingredients and define the mechanisms of XSJ to develop multiple applications, and further studies on the dose range between its hepatoprotective activity and hepatotoxicity are necessary to improve the safety of the clinical application. In this review, the current problems are discussed to facilitate the reference basis for the subsequent research on the development of XSJ and future application directions.