Medicinal plants grown outside their native forest habitat may produce phytochemical profiles that differ from wild-harvested material, yet the ecological mechanisms underlying these differences remain poorly synthesized across disciplines. This review proposes that the forest understory functions as a multi-signal elicitation system in which canopy light filtering, arbuscular mycorrhizal fungi (AMF), and above-ground biotic interactions collectively shape secondary metabolite profiles. AMF-mediated induced systemic resistance and above-ground biotic interactions operate through confirmed jasmonate-mediated pathways. Sunfleck-driven reactive oxygen species signaling is hypothesized but untested, and the red-to-far-red ratio modulated phytochrome B pathway characterized in Arabidopsis remains unconfirmed in shade-tolerant species. Using three saponin-rich herbs (Panax vietnamensis, P. ginseng/P. quinquefolius, and Paris polyphylla) as case studies, we formalize this as a testable chemical terroir hypothesis with three falsifiable predictions. We also translate it into an ecological co-cultivation design principle with three production levels and a two-step operational framework, and identify priority experiments, analytical methods, and implementation challenges needed for validation. These contributions bridge forest ecology and medicinal plant science while identifying critical evidence gaps requiring resolution before field implementation.