Bhut Jholokia, or "Bhut Jolokia" or "ghost pepper" (Capsicum chinense Jacq.), is one of the world's hottest chili varieties and an important part of the ethnobotany of northeast India. Its high capsaicinoid content has created a lot of interest in its phytochemical chemistry and wide range of biological activities, such as analgesic and anti-inflammatory activities, antimicrobial and anticancer activities, metabolic modulation, and possible cardiovascular benefits. This review offers a concise synthesis of its botanical characterization, traditional therapy, phytochemical profile, pharmacology, toxicology, and agronomic and quality concerns. It also highlights current knowledge gaps and suggests research priorities for upcoming translational and clinical investigations.