Disease outbreaks increase proportionally with increases in intensive aquaculture. Natural products including medicinal plants have been known from thousands of years for treating some human diseases. It is well known that many active compounds are responsible for potential bio-activities. For that reason, there has been considerable interest in the use of medicinal plants in aquaculture with a view to providing safe and eco-friendly compounds for replacing antibiotics and chemical compounds as well as to enhance immune status and control fish diseases. This article describes a wide range of medicinal plants such as herbs, seeds, and spices with different forms such as crude, extracts, mixed and active compounds, used as immunostimulants and resulting in a marked enhancement in the immune system of fish to prevent and control microbial diseases. Moreover, different activity was recorded from plant parts like seeds, roots, flowers and leaves. The mode of action of medicinal plants was stimulation of the cellular and humoral immune response which was monitored through elevation in immune parameters. Various levels of immune stimulation have been shown by medicinal plants at different concentrations through injection or immersion or oral administration. However, it is critically important to determine the optimal dose to enhance the immune system of fish and avoid the risk of immunosuppression. Some medicinal plants have been used to replace the protein in fishmeal as a cheap source of protein and proved to be efficient in this respect. Medicinal plants can act as a growth promoter and immunomodulator at the same time. Further investigations should be carried out to examine the influence of those plants on fish health (including physiological and histological parameters) as a preliminary step for use in large scale in aquaculture. The current review describes the role of medicinal plants and their derivatives on innate and adaptive immune status as well as growth performance in fish.