Meticulous plaque control on a daily routine basis is the single most important step to achieve good oral health. Herbal chewing sticks, commonly known as Miswak, are among the ancient and traditional oral hygiene aids popular in India, Pakistan, most of the Arabian countries, and several African countries. But nowadays, because of low cost, free availability, unique chemical composition, and spiritual beliefs, miswak is being used worldwide. A large number of studies have proved that miswak is as effective as, or even superior to the present day′s most common oral hygiene aid, i.e., toothbrush. The aim of this review article is to discuss various pharmacological and therapeutic aspects of miswak and also to compare the effectiveness of miswak with modern toothbrushes in terms of oral hygiene practice.