It is known by the common name round leaf buchu and has historically been used as a flavoring agent and an herbal remedy. The very similar plant Agathosma crenulata (previously Barosma crenulata) is known as the oval leaf buchu, and has been used for the same purposes.
Wild plants of this species are still plentiful but are being harvested faster than they can reproduce. The threat of their becoming scarce has led to efforts to cultivate them.
The essential oils and extracts of the leaves are used as flavoring for teas, candy, and a liquor known as buchu brandy in South Africa. The two main oils of A. betulina are isomenthone and disphenol. The extract is said to taste like blackcurrant. It has historically been used as a medicine for urinary tract disorders and wounds.