The aim of this study is to look at how pepper was used in traditional medicine. In other words, this study aims to take a look at the process by which the medicinal nature & efficacy of pepper in traditional society was perceived and arranged through the aspects of the use of pepper as an exotic crop for treating diseases. This study investigated cases of using pepper for medical treatments by referring to books on traditional medicine in Korea. The old records about pepper are mainly in empirical medical books from the late Chosun dynasty. Nevertheless, the records about pepper tend to decrease in medical text as time goes by. Such a phenomenon can be attributable to the fact that people began to use pepper for daily food life rather than for medicinal purposes. Pepper was used mostly for digestive trouble such as vomiting, diarrhea, and stomachaches, and it was also applied to mental and aching diseases caused by the sound of body fluids remaining in the stomach. In addition, there were many cases where pepper was used externally for surgical disorders. Such symptoms for treatment are linked to, or in a complementary relationship with, research results in modern times. Boiled pepper was generally taken in the traditional herbal decoction method, and in the case of surgical diseases, it was applied externally. The cases of using old pepper, using pepper with seeds or without seeds, and using pepper mixed with sesame oil belong to a sort of herbal medicine processing, which usually aimed at changing the medicinal nature of pepper. In addition, in relation to the eating habits at that time, pepper was used as seasoning and to make red pepper paste with or without vinegar. There are two words used for pepper in the medical textbooks, 苦椒 (gocho) and 烈棗 (yeoljo). These words are translated into Korean as gochu, so we can identify this word as a nickname for pepper.