(+)-Nootkatone, first isolated from the heartwood of Alaska yellow cedar (Chamaecyparis nootkatensis), is a non-food natural sesquiterpene ketone. Due to its strong grapefruit aroma and wide range of biological activities, there is a growing demand for (+)-nootkatone in the food, cosmetic, pharmaceutical, and chemical industries. Therefore, there is a need to combine the latest and previously available information to understand the research status of (+)-nootkatone and to pave a way for the further development of (+)-nootkatone and its analogs. The present work reviews the research progress in the plant sources, chemical synthesis, biosynthesis, and structural modifications of (+)-nootkatone, and the pesticidal and other physiological activities of (+)-nootkatone and its derivatives. We hope this work can provide a reference for the further application of (+)-nootkatone and its analogs in the food, cosmetic, pharmaceutical, and chemical industries.