The development of concentrated herbal extract powders, commonly known as "granules,” has had a major impact on the field of Chinese medicine. The consistent and easily quantifiable nature of granule extracts makes them well suited to evidence-based medical research, while the portability and convenience of granules dramatically increases patient compliance. Granule formulas can be extensively customized and deliver a comparable level of potency to raw herb decoctions, but granules have a longer shelf life and require less space and preparation than their raw counterparts. Most practitioners appreciate the degree to which these important factors affect our day-to-day clinical practice, but few practitioners are aware of the larger trends surrounding the use of granules in Asia. While granule use has produced a number of new approaches to prescription formulation and dosage in Asia, these clinically essential developments are only just now beginning to be appreciated in Western countries.