Cold desert regions harbor a unique habitat for a number of high-value medicinal plants (HMPs) and due to inaccessibility of medical facility, inhabitants of this region are highly dependent on medicinal plants. Over the years, with increasing demand for trade, extraction pressure on natural populations of these HMPs has grown substantially. This consequently has made such plants threatened in their natural habitats. However, quantification of threat intensity is lacking. For the first time, this study has attempted to identify and assess the ecological and threat status of HMPs from the cold desert area of Johar valley, West Himalaya, India. For ecological assessment, rigorous field surveys were conducted along the elevation gradient. The intensity of threat was evaluated by using rapid threat assessment (RTA) approach. A total of 22 threatened and high-value medicinal plants (THMPs) were identified from the region. Results of RTA placed Betula utilis and Nardostachys jatamanasi in the highest threat category. Roots/rhizomes were the frequently (55%) used plant parts, followed by inflorescence/fruit and stem/bark (18%) each. Overall, this study provides a clear picture of ecological and threat status of THMPs of the study area, which can effectively be utilized to develop a suitable conservation model for the region.