Urban primary care clinics increasingly encounter patients seeking cannabidiol (CBD) for sleep disturbances, anxiety, stress-related symptoms, chronic pain, and women’s health concerns. CBD lies at the intersection of clinical medicine, legal regulation, product quality, public understanding, and ethics. In several East Asian settings, regulatory and quality standards are still evolving, creating uncertainty in routine clinical practice.To describe the real-world experience of CBD-related consultations in an urban primary care clinic and to identify patient needs, regulatory barriers, and ethical considerations in a rapidly changing healthcare environment.Cases were extracted from an urban primary care clinic located in a major metropolitan area in East Asia, where patients presented specifically to request CBD prescriptions or seek guidance regarding CBD use. Each case was analyzed for presenting symptoms, safety concerns, and informational needs. In parallel, domestic and international regulatory documents were reviewed to compare legal classifications, product quality standards, and levels of public literacy.The most common patient concerns were sleep disturbances, anxiety, stress-related symptoms, and women’s health issues. Patients sought neutral and medically grounded explanations regarding potential benefits, risks, drug–drug interactions, and product variability. In the local context, inconsistent product standards and ongoing changes in legal classification contributed to widespread misunderstanding and safety concerns. For clinicians, the absence of standardized product testing and clear oversight mechanisms further complicated clinical judgment and risk assessment.CBD may offer supportive benefits for selected conditions; however, fragmented regulations, variable product quality, and limited long-term data create barriers to safe use. Differences in national health systems and cultural and ethical expectations further contribute to variation in clinical integration. Primary care physicians must carefully balance patient autonomy with safety amid commercial influences and regulatory uncertainty.The integration of CBD into urban primary care requires careful attention to legal context, product quality, safety, and ethical responsibility. Primary care clinicians play a key role in providing unbiased information and supporting shared decision-making. Strengthened regulatory standards, improved product oversight, and international knowledge exchange are essential for establishing safe and equitable cannabinoid care.