In the past year, the medical regulation of psilocybin-assisted therapy has expanded across additional international jurisdictions, requiring an update to the original medico-legal synthesis. Newly established or clarified regulatory pathways in New Zealand, Germany, Switzerland, the Czech Republic, and at the United States federal level reflect continued evolution in therapeutic governance. Within the United States, Utah and New Mexico have now joined Oregon and Colorado in establishing lawful medical access pathways. These developments build upon earlier reforms in Alberta, Canada and Australia, where structured psychiatric prescribing frameworks were implemented.This update consolidates recent statutory amendments and regulatory decisions to provide a current comparative overview of jurisdictions permitting lawful medical use of psilocybin. By distinguishing comprehensive medical regulation from restricted or exceptional access schemes, this revised analysis maintains clarity within an increasingly dynamic global regulatory landscape.