This review examines the research progresses on carcinogenicity and toxicity of areca nut in recent years. After summarizing the carcinogenic components, carcinogenicity and toxicity, and the relationship with the incidence of malignant cancers, the review focus on the mechanism of areca inducing cancer, especially oral cancer, and its reproductive toxicity and neurotoxicity. Finally, the review concentrates on providing references for the prevention and treatment of oral submucosal fibrosis, oral cancer and other malignant diseases.