Aim: The aim of this study was to investigate the current circumstances of pharmacoeconomic evaluation of Kampo therapy, by carrying out qualitative analysis of articles on the economic evaluation of Kampo therapy published over the last 30 years from an evidence-based medicine viewpoint. Methods: The Japan Medical Abstracts Society (JAMAS) Web Ver. 5 was searched for reports relevant to cost-effectiveness evaluation in Japan published between 1983 and 2013. Search terms used were 'Kampo', 'economics', and 'cost'. Cited references were also included. Results: A total of 22 articles relevant to the economic evaluation of Kampo medicines were extracted. A total of 27 sets of results were ultimately obtained. Of the 27 studies, 16 covered direct costs (pharmaceutical costs only), 7 covered direct costs including non-pharmaceutical medical costs, and 3 covered direct costs and indirect costs. Costs were reduced by Kampo therapy for 25 studies. Conclusion: Many economic evaluation studies of Kampo therapy have small control groups and low evidence levels. The cost-effectiveness of Kampo medicines needs to be demonstrated through integrated, objective, and proactive evaluations. Implementation of high-quality economic evaluation studies on various Kampo therapies is therefore needed.