Betelvine (Piper betle L.) is cultivated as a cash crop in many countries of Asia for its green leaves. The leaves are extensively used for chewing purposes. It also has antioxidant, anti-inflammatory, anti-apoptotic, anti-cancer, and anti-microbial activities. Besides, the leaves comprise the chavibetol-rich essential oil, widely used as an antiseptic, cardiotonic, blood pressure lowering, and cardiac as well as respiratory depressant properties. Despite its great economic potential, the crop faces serious spoilage due to disease and pest attacks. The unavailability of proper marketing, storage facilities, and changing prices are the key factors in the huge wastage of surplus betel leaves. The shelf life of betel leaves depends on the storage conditions but can range from a few days to over 40 days. These unmarketable leaves could be utilized for the extraction of essential oils and the development of value-added products like bars, tonics, perfumes, and food additives. The betelvine essential oil indicates a promising market in food, medicine, and other sectors in the future due to its bioactive and aromatic constituents. The present chapter focuses on the traditional and functional use of betel leaves and the extraction of essential oil for future utilization and livelihood generation.