Environmental extremes such as high temperature, cold, alkalinity, drought, and rocky substrate modulate plant growth and promulgate adaptive characteristics in plants. The same plants can be found inhabited in different life forms, namely epiphytic, lithophytic, terrestrial, halophytic, and psammophytic, based upon adaptive characteristics essential for their survival. Microorganisms residing on the surface or within rocks make a unique habitat referred to as “lithobiontic habitat,” which further facilitates weathering phenomena and accumulates water and nutrients from the ecosystem to form a lithobiontic ecological niche. Lithobionts are divided into two groups, namely epiliths and endoliths, based on their presence on rock surfaces. Lithophytes, the rock-inhabiting plants, thriving under extreme stress conditions adapted successfully and their extraordinarily challenging atmosphere encouraged them to make new forms of life. Many biotic and abiotic factors are responsible for dwelling in such environments. Lithophytes interact with their surroundings to obtain vital elements necessary for their metabolism and, because of natural selection, their morphology and physiology help them with better adaptation. Another factor that facilitates such adaptation in lithophytes is the association of a fungus with lithophytic roots to ensure nutrient supply for their survival and facilitate growth in extreme conditions. Arbuscular mycorrhizal (AM) root fungal associations commonly found among plants under stressed conditions help hosts adapt and promote plant life. In lithophytes, AM association aids in nutrient uptake from soil and facilitates plant survival under harsh conditions. The present review provides a comprehensive account of lithophytic life forms and covers different aspects of rock-dwelling plants concerning their historical background, classification, habitat, distribution in various families, root adaptive mechanisms, and phytopharmacological status. This review focused on plant species that can be considered among the most common representatives of lithophytes. This manuscript furnishes insights into different perspectives on the ecological and biological properties of the most common lithophytic species adapted to extreme rocky structures and explains their wide array of applications for pharmacological use.