A substantial portion of the murals and manuscripts housed in the Sutra Caves of Dunhuang is intimately tied to the cult of the Medicine Buddha. An examination of the Catalogue of Dunhuang Mogao Caves compiled by the Dunhuang Academy, alongside the New Catalogue of the Dunhuang Manuscripts edited by Huang Yongwu, reveals the presence of 295 texts pertaining to the Medicine Buddha, underscoring the prevalence of this belief system in Dunhuang. The popularity of the Medicine Buddha belief in the region emerged as a pivotal factor influencing the evolution of sutra illustrations’ content and form. The Medicine Buddha’s attributes of averting calamities, curing illnesses, and prolonging life—all catering to worldly aspirations—resonated deeply with people’s pursuit of immediate benefits in this life. This paper employs a multifaceted approach, encompassing documentary research, iconographic analysis, and comparative studies, to trace the historical trajectory and graphical transformations of the “Medicine Buddha Sutra Illustrations” (Yaoshijing Biantu), culminating in a comprehensive synthesis. Furthermore, by delving into the societal backdrop, the underlying economic underpinnings, and the evolving “compositional strategies” of these illustrations across various eras, we aim to present a holistic view of the dynamic development of the Medicine Buddha Sutra illustrations throughout time.