Over the past 15 years, psychedelic treatments have gained a lot of clinical interest, with psilocybin and MDMA advancing to phase 3 clinical trials for a variety of psychiatric conditions. Treatments combine limited medication administration with psychotherapy or psychological support and work through both biological and psychological mechanisms, such as effects on neural circuitry, emotional processing, and psychological flexibility. The strongest evidence supports psilocybin for treatment-resistant depression and MDMA for PTSD, with new data for substance use disorders and anxiety in life-threatening illnesses. In controlled settings, psychedelics are well tolerated, but the evidence is complicated by methodological limits, such as functional blinding, variable psychotherapy protocols, and homogeneous patient groups. Current models require extensive therapeutic support in specialized settings, making scalability difficult. Innovative approaches such as group therapy may improve accessibility, but their effectiveness remains to be verified. Future priorities include standardization of adverse event assessment, development of implementation guidelines, and demonstration of long-term benefit in diverse patient populations.