Evodiamine (EVO) is a major alkaloid compound extracted from the dry unripened fruit Evodiae fructus (Evodia rutaecarpa Benth., Rutaceae). EVO has a variety of pharmacological activities, such as anti-obesity, anti-allergenic, analgesic, anti-tumor, anti-ulcerogenic, and neuroprotective activities. EVO has varying efficacies in animal models and humans. Here, the physicochemical properties of EVO are presented, and the EVO's functions and mechanisms of action in various chronic diseases are reviewed. EVO is worth exploring in more depth in the future for its potential use in various chronic diseases.