Different elements of the pomegranate, both tree and fruit, had a wide range of uses in premodern therapeutics. Pomegranate also had a rich symbolic role in the art, literature, and religion of numerous cultures. In nearly every part of the globe where the pomegranate grew, it came to represent fundamental dualities: life and death, inside and out, many and one. The medicinal purposes for which healers recommended pomegranate at times reflected broader symbolic associations, and those associations are an important part of the therapeutic tradition. The dualistic symbolism that attended the pomegranate in various cultural traditions synergized with dualistic medical concepts, reinforcing the therapeutic power of pomegranate in otherwise diverse contexts. Reflecting this duality, pomegranate was both an astringent and a laxative, an emmenagogue and an antimenorrhagic, an expectorant and an antiemetic, a pyrogen and a febrifuge, a restorative and a soporific. In both literary and medical traditions, the pomegranate mediated transitions—or maintained balance—between opposing states. This essay provides an overview of the rich and sundry uses of pomegranate in premodern therapeutics, revealing how cultural associations both reflected and informed medical practices.