Pyrethrum (Chrysanthemum cinerariifolium (Trev.) Vis. = Tanacetum cineariaefolium (Trev.) Schultz-Bip.) is a perennial herbaceous plant belonging to the family Asteraceae, native to Albania and the area of former Yugoslavia. It is the only species in the genus Tanacetum having an agronomic importance, although the genus consists of several species producing similar types of bioactive metabolites. The species is grown in order to obtain the insecticidal compounds collectively termed pyrethrins, which are found primarily in the flower heads. In this work we discuss the results found from a worldwide literature review about the micropropagation techniques followed on Pyrethrum, the in vitro culture conditions, and the ex vitro establishment trials under Mediterranean environmental conditions. Many technical problems concerning the propagation of the species seem to have been solved, and detailed protocols are available for an easy and fast propagation by seeds, vegetative splits, stem cuttings (rooted under mist or not), and tissue culture. The first attempts to introduce its cultivation into the semi-arid Mediterranean environments have brought to satisfactory results, and the species may be suggested as a valuable opportunity for the development strategies in new Mediterranean farming systems.