Background: Conservation of useful plants can be maintained and enhanced once the nature of a cultural landscape and knowledge and principles of resource utilization are understood. We studied the factors influencing indigenous knowledge of medicinal plant collection and utilization in the lower Kailash Sacred Landscape, Nepal. <p> <p> Methods: A total of 62 respondents aged ≥ 60 years, including 42 plant collectors and 20 traditional healers from nine villages of Baitadi, Dadeldhura and Darchula districts, far western Nepal were consulted for this study following snow-ball sampling and village references. <p> <p> Results: Results showed that the area is rich in useful plants and indigenous therapeutic knowledge. One hundred and sixty medicinal and 75 non-medicinal plant-uses from 44 species were documented from 30 sample respondents. The average number of useful plants reported by healers and elders was expectedly higher (11.4 } 4.19) than the knowledge of laypeople. Women were more knowledgeable in identifying the useful plants. When classifying 27 uses according to the level of species redundancy, we found that 20 uses were ‘not very redundant’, six ‘redundant’ and one ‘highly redundant'. <p> <p> Conclusion: Even though the life form and plant availability influence the plant use, the accessibility of habitats where the plant grow has stronger association with the plants’ usefulness. The large number of ‘non-redundant’ uses indicates that plant use in study area is specific. The recent changes in socio-economy, culture, environment and land use plague the conservation of plants resulting in jeopardy in integrity of plants, people and places.