The products derived from the balsam tree (probably a cultivar of Commiphora opobalsamum [L.] Engl.) were employed extensively in medicine during the medieval period. This article presents a preliminary survey of the Arabic and European texts which discuss the varied medical uses of balsam. The analysis of the medical applications of balsam is organized into broad categories according to groups of illnesses and treatments. Although other sources of medicinal oleo-resin were available in the medieval period, the balsam gathered from the trees in the walled plantation at Matariyya in Egypt enjoyed a pre-eminent status. It is argued that the great regard shown to balsam in medieval medicine must be seen in the wider context of the history and legends associated with Matariyya and the earlier plantations in Palestine.