Hawthorn berries have been traditionally used to strengthen the cardiovascular system. Hawthorn leaf, flower, and berry have been praised over the centuries for their heart elevating properties. Believed to uplift and strengthen both the physical and emotional heart, hawthorn, as it supports healthy cardiovascular function, was also revered for ceremonial and spiritual purposes. The flavorful red berries have been used in candies, jams, jellies, wines, and cordials and are widely available in many forms as dietary supplements.

Hawthorn has been used for healing since the Middle ages, with some accounts going back as far as the first century to Greek herbalist Dioscorides. It was later used by Swiss physician Paracelsus (1493–1541 CE). Considered to be a particularly symbolic tree with many folktales and magical myths surrounding it, hawthorn was "sacred tree medicine" to the ancient Druids, and was said to house fairies, specifically when growing with oak and ash trees. However, it was unlucky to bring the flowers into the house, quite possibly because they would bring the fairy folk with them.

In Ireland, couples desiring hawthorn's blessing would dance around it at marriage ceremonies. The sprigs were attached to newborn's cradles to protect them from evil and also used to decorate the maypole for the May Day or Beltane ceremony, which celebrated fertility and renewal. The blooming of this tree coincided with the first day of summer which occurred in May.

In the traditional medicine of Europe all parts of the tree were appreciated and utilized: leaves, berries, flowers, and the wood. The blossoms were used as a heart tonic and a diuretic, and the berries and leaves were made into an astringent tea to soothe throats. Additionally, the wood was carved into smaller objects such as boxes and combs and burnt as fuel producing wood fires that were extremely hot. Hawthorn or 'shanzha' has been used in traditional Chinese medicine (TCM) since ancient times to support digestion, however, presently, it is used to support the cardiovascular system as well, and in fact, in China, the berries are so popular that they are made into hawthorn candies that are similar to the 'fruit roll-ups' in the West.