Since ancient times humans have used a variety of plants and animals to both prevent and treat ailments. Hirudotherapy is a traditional treatment modality using medicinal leeches. In both traditional and modern medicine, medicinal leeches have been important in the treatment of eczema, chronic ulcers, psoriasis, osteoarthritis, thrombosis, and hypertension. Hirudotherapy is a trustworthy, easy‐to‐use, helpful, and affordable treatment option for draining blood from deeper tissues in localized venous congestion related with surgical replantations and flap reconstructions. Hirudotherapy has also been commonly used to treat soft tissue oedema and haematomas in trauma situations. Throughout the feeding process, leeches secrete biologically and pharmacologically active components into the wound. This article aims to present a broad assessment of the potential use of hirudotherapy, indications, contraindications, and therapy-related complications. Providing detailed evidence-based information about the usage areas of hirudotherapy will help spread healthy medicinal leech practices and prevent possible complications, thus infectious diseases and public health problems.