Generally, elderflower has an anti-inflammatory action, attributed to the presence of the ursolic acid. The benefits are mostly directed at the respiratory system; it is a specific for nasal catarrh. Elderflower is also useful for allergies, such as hay fever and allergic rhinitis. Elderflower has a diaphoretic effect which encourages the loss of toxins through sweating, so is particularly useful in colds and flu, where it will lower a fever and reduce excess catarrh. It will in addition relieve earache where this is due to the buildup of mucous, and is also used as a gargle for sore throats. Finally, elderflower works on the urinary system, having a mild diuretic effect, again encouraging the elimination of waste material, which is helpful in arthritic conditions.

Elderflowers taken in hot infusion make a wonderful remedy for the onset of upper respiratory infections - colds, tonsilitis, laryngitis and flu. With the first signs of malaise, aching, sore throat, chills, restlessness and fever, elderflowers will stimulate the circulation and cause sweating, cleansing the system by elimination of toxins through the pores of the skin and in this way they resolve fever and infection.

They are also recommended at the onset of eruptive diseases such as measles and chickenpox, to bring out the rash and speed recovery. They also have a decongestant action, reducing and moving phlegm, and can be taken in hot infusion (combined with yarrow and peppermint) for an ideal remedy for colds, catarrh, sinusitis, hay fever and bronchial congestion in chest infections and asthma.

The relaxant effect of elderflowers is a bonus where asthma is concerned, relieving bronchospasm and catarrh.
Elderflowers enhance the action of the kidneys and so act further as a decongestant, relieving fluid retention in the body and eliminating toxins and clearing heat from the system via the urinary system. They have been used in rheumatism, gout and arthritis.

Elderflowers have a long history of use as a relaxant, soothing nerves, allaying anxiety and lifting depression. A hot infusion at night time will help induce a restful sleep and is particularly useful for restless or irritable children at the onset of infections.
Elderflowers in infusion or ointment are used externally on cuts and wounds, chilblains, skin eruptions, sunburn, and irritable skin.

Elder flower tea is used to "break" a fever by bringing on sweating. Elderflower is used especially for situations in which the feverish person feels chilled, and the tea is drunk as hot as possible. A cooled infusion has traditionally been used as a gargle for sore throat. Elder flowers are believed to have mild diuretic action.