Abstract: Buffalo horn is the horn of Bubalus bubalis Linnaeus. It has the effect of clearing heat and cooling blood, resolve toxin and stabilize fright. It is mainly used to treat febrile diseases, high fever, clouded spirit and dilirious speech, macular eruption and exanthema, blood ejection and spontaneous external bleeding, fright wind, mania and withdrawal, etc. In this paper, we consulted the herbal books and documents of the past dynasties, and systematically sorted out the basis of buffalo horn, its properties, taste, compatibility and application, material composition, identification and quality evaluation methods, biological effect evaluation, modern clinical application and application history as a substitute resource for rhino horn. To provide research ideas and strategies for further clarifying the efficacy and material basis of buffalo horn, the mechanism of action and the improvement of quality standards. Through the combing and condensing of this paper, it provides a basis and reference for the basic and applied research of buffalo horn, and provides a scientific theoretical basis for improving the quality and efficacy evaluation system of buffalo horn and promoting the sustainable development of traditional Chinese medicine resources industry.