This special issue on Advances in Cannabinoid Quantification by Clinical Mass Spectrometry showcases methodological and translational work that strengthens the analytical foundations of cannabis testing in the clinical laboratory. Contributions focus on optimizing LC–MS/MS workflows for key cannabinoids and metabolites, including sample preparation (e.g., enzymatic hydrolysis), derivatization strategies, chromatographic separation, and transition selection for improved sensitivity and specificity. Together, these articles highlight practical solutions to matrix effects, robustness, and throughput in routine testing environments, with an emphasis on methods that can be adopted, validated, and sustained in real-world clinical and toxicology laboratories.