Successful crop production and optimum yields, regardless of the species, can be accomplished only when maximum stand establishment is achieved. Stand reduction after planting typically results in reduced yields and lower crop quality. Several classes of factors (environmental, edaphic, biotic) contribute to successful stand establishment in crop production and should be considered in growing medicinal plants. Environmental factors (e.g., temperature and moisture extremes) as well as pathogens and insect pests that attack seeds and seedlings may contribute to reduced stands. Soil related factors such as pH, nutrient availability, and crusting may also restrict seedling growth. Understanding the requirements for optimum seed germination and the environmental conditions into which the seed is sown is essential for uniform crop establishment. Vigor tests can aid growers in determining the optimum temperature range for seed germination. Many cultural practices may also influence soil related factors and contribute to successful stand establishment in the field. Seed vigor tests (SSAA, thermogradient results) along with seed treatments and enhancements can assess seed vigor, improve germination and lead to more reliable stands of medicinal species.