As a middle-income country, Thailand has taken a bold step in legalizing cannabis, becoming a pioneer in the worldwide trend, and following the lead of Canada and Uruguay. With Thailand being the first country in Southeast Asia to legalize cannabis, its experience is drawing widespread attention, including from neighboring countries such as Malaysia that are exploring the possibility of using cannabis for medical purposes. While much can be learned from Thailand's experience, cannabis policymakers must keep in mind the delicate balance between the benefits of medical cannabis and its potential public health consequences and cost. The full impact of Thailand's legalization is still unfolding, and policymakers must remain vigilant in considering the various implications of this move.