Throat infections, including conditions like pharyngitis, tonsillitis, and laryngitis, are highly prevalent across various age groups. These infections are caused by bacteria, viruses, or fungi and present symptoms such as sore throat, fever, and difficulty swallowing. Conventional treatment mainly includes antibiotics for bacterial infections; however, rising antimicrobial resistance (AMR) has become a significant challenge, limiting the effectiveness of such treatments. As a result, there is increasing interest in alternative, natural remedies for the management of throat infections, particularly those derived from plants with antimicrobial and anti-inflammatory properties. Justicia adhatoda (Vasaka), a perennial shrub native to South and Southeast Asia, has been widely used in traditional medicine systems such as Ayurveda, Unani, and Siddha for the treatment of respiratory conditions, including throat infections. The plant’s therapeutic efficacy is attributed to its rich phytochemical profile, which includes alkaloids such as vasicine and vasicinone, flavonoids, saponins, tannins, and essential oils. These bioactive compounds collectively exhibit potent antimicrobial, anti-inflammatory, antioxidant, and mucolytic effects, making J. adhatoda a promising candidate for the treatment of throat infections. Pharmacological studies have demonstrated that the plant’s bioactive constituents inhibit microbial growth, reduce inflammation, promote mucus clearance, and enhance immune function, all of which contribute to its efficacy in treating throat infections. Furthermore, traditional preparations of J. adhatoda, such as decoctions, teas, and syrups, are being integrated into modern formulations that enhance bioavailability and efficacy. Despite its promising therapeutic potential, further research is required to standardize formulations, establish optimal dosages, and explore its synergistic effects with other natural compounds or synthetic drugs. This review aims to provide a comprehensive overview of J. adhatoda, highlighting its botanical characteristics, phytochemical composition, traditional uses, mechanism of action in treating throat infections, and pharmacological studies. By doing so, we aim to evaluate its potential as an effective and sustainable alternative to conventional antibiotics in managing throat infections, especially in light of the growing AMR crisis.