Though often used in medieval times in spice mixes like “strong powder”, long pepper is today a very rare ingredient in European cuisines, but it can still be found in Indian and Nepalese vegetable pickles, some North African spice mixtures, and in Indonesian and Malaysian cooking. It is readily available at Indian grocery stores, where it is usually labeled pippali. Pippali is the main spice of Nihari, one of the national dishes of Pakistan and the Indian metropolis of Lucknow.

Long pepper is an important and common ingredient in many medicines of Ayurveda.