Abstract: Objective To introduce the Medical Dictionary for Regulatory Activities (MedDRA) Terminology, a medical terminology developed under the auspices of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) and the use of MedDRA in the regulatory area. Methods The need for an international standard terminology in the 1990s was traced, the structure and maintenance of MedDRA were illustrated, the milestones of MedDRA's growth and development were listed, including its recent actions to meet the challenges of the COVID-19 pandemic, and the future developments of MedDRA were outlined. Results and Conclusion MedDRA by ICH resulted from the need for an international standard terminology that could meet the regulatory needs in pharmaceutical research and development. MedDRA has been used in the registration, documentation, safety monitoring and oversight of medicinal products through each phase of the pipeline, from clinical trials to post-marketing surveillance. The structure and maintenance model of MedDRA can facilitate its use. Since its inception as a user-driven terminology, MedDRA has grown in volume and expanded in scope under the care of the Maintenance and Support Services Organization (MSSO) to meet the needs of users and of evolving regulatory reporting and to keep up with the advances of medicine.

Key words: MedDRA, analysis query, user-driven terminology